For smaller kidney tumors, doctors may recommend a partial nephrectomy. This surgery involves removing only part of your kidney. A robotic approach may reduce your recovery time and risk of complications.

A partial nephrectomy is a surgical procedure to remove a portion of your kidney while preserving as much healthy tissue as possible. It’s also called nephron-sparing surgery.

This technique is one of the preferred treatment options for small to medium kidney tumors, renal cell carcinoma, and other conditions that can affect your kidneys. It offers a high chance of cure while preserving the best possible kidney function.

Surgeons may use different approaches for partial nephrectomy, depending on several factors.

This guide explores the various aspects of partial nephrectomy, including its purpose, surgical techniques, benefits, potential side effects, and outlook.

The primary purpose of a partial nephrectomy is to remove the tumor or cancerous growth and the surrounding affected tissue while preserving as much healthy kidney tissue as possible. This helps eliminate the cancer and reduce its risk of returning.

A partial nephrectomy also aims to preserve your kidney function. Your kidneys help filter waste products and produce urine, which is vital for your overall health. By sparing as much healthy kidney tissue as possible, partial nephrectomy helps minimize the risk of kidney failure or the need for dialysis in the future.

Partial vs. radical nephrectomy

Partial nephrectomy involves removing the tumor or damaged portion of your kidney while preserving the healthy tissue.

Radical nephrectomy involves completely removing the affected kidney and surrounding tissues, including lymph nodes. Doctors often recommend this approach for larger tumors or cancer that has spread beyond the kidney.

Doctors typically select partial nephrectomy for tumors smaller than 4 centimeters (cm), or about 1.5 inches (in), wide but may also use this procedure for tumors up to 7 cm (a bit less than 3 in) wide.

While both procedures have benefits, partial nephrectomy offers the advantage of preserving kidney function. However, the choice between the two will depend on tumor size, stage, and location, as well as your overall health.

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There are two common approaches to a partial nephrectomy: open and robotic.

Open partial nephrectomy is a traditional surgical approach that involves making larger incisions in your abdomen to access your kidney. This method allows the surgeon to see and manipulate your kidney tissue directly.

While effective, open partial nephrectomy may result in longer hospital stays, more postoperative pain, and a higher risk of bleeding than the robotic approach.

In contrast, robotic partial nephrectomy is a type of laparoscopic surgery. It’s a minimally invasive procedure in which the surgeon controls robotic arms to perform the surgery through several smaller incisions.

The smaller incisions reduce scarring and provide a better cosmetic outcome. Robotic partial nephrectomy also offers greater precision for the surgeon, allowing for better preservation of healthy kidney tissue.

Robotic partial nephrectomy has been linked to:

  • shorter hospital stays
  • reduced blood loss
  • milder pain
  • reduced recovery time
  • lower complication rates

Doctors follow several steps to safely remove the tumor or cancerous growth during a partial nephrectomy.

Step 1: Anesthesia

A healthcare professional will give you anesthesia to ensure that you’re completely asleep and pain-free during the surgery. Your medical team will determine the most appropriate type of anesthesia for you.

Step 2: Incision

Depending on the tumor’s location, the surgeon will make an incision in your abdomen or your side. The size and placement of the incision may vary depending on whether you have an open or a robotic partial nephrectomy. Incisions for robotic surgery are typically smaller.

Step 3: Accessing your kidney

After making the incision, the surgeon will carefully access your kidney. An open partial nephrectomy exposes the kidney directly through the incision. In a robotic partial nephrectomy, the surgeon views your kidney with a camera that they insert through a small incision.

Step 4: Tumor removal

The surgeon will identify and carefully remove the tumor or cancerous growth along with a small margin of healthy tissue around it. This margin is important to ensure complete cancer removal while maintaining enough kidney tissue for proper function.

Step 5: Kidney closure

After removing the tumor, the surgeon will close the incision in your kidney using sutures or other sealing devices. This step helps prevent postoperative bleeding and ensures the structural integrity of your kidney.

Step 6: Incision closure

In an open partial nephrectomy, the surgeon will close the incision in your abdomen using sutures or staples. In a robotic partial nephrectomy, they’ll use sutures or specialized adhesive strips to close the incisions.

Commonly reported side effects of partial nephrectomy include:

  • pain and discomfort in the surgical area
  • a temporary decrease in kidney function
  • bleeding at the surgical site
  • infections
  • fluid collection (seroma) near the incision site
  • negative reactions to anesthesia or medications

These side effects are typically temporary. Your healthcare team can provide proper medical care and support to help you manage them.

After a partial nephrectomy, you can expect to stay in the hospital for a few days. You may need to stay for up to 7 days while your medical team monitors your recovery.

Pain, fatigue, and mobility restrictions are common after the surgery. A healthcare professional will provide you with medications and guidance on managing symptoms.

Full recovery may take several weeks or months, but most people recover within 6–12 weeks. Follow-up appointments and imaging tests will be necessary to monitor your kidney function and ensure proper healing.

First, you may need preoperative tests, such as CT scans and blood tests, to assess your overall health. A doctor may tell you to fast before the surgery or make medication adjustments.

You can also plan for your recovery by arranging for support at home, ensuring a comfortable environment for rest, and mentally preparing yourself for the procedure. A healthcare professional will provide specific guidance according to your needs.

Your outlook after partial nephrectomy can vary depending on several factors, such as the extent of the surgery and the underlying condition being treated. However, both open and robotic partial nephrectomy have shown good long-term survival rates for people with kidney cancer.

A 2013 study found that open partial nephrectomy had a 5-year survival rate of about 92%, while robotic partial nephrectomy had a 5-year survival rate of 94%. However, continued follow-up care and monitoring are vital for kidney function and overall health after surgery.

Partial nephrectomy involves removing only the affected part of your kidney and some surrounding tissue. It’s the standard treatment for tumors smaller than 4 cm wide, but doctors sometimes use it for tumors as large as 7 cm wide.

Surgeons can choose between open and robotic surgery. Open surgery may be more invasive and require a longer recovery time, but it may be the better choice in some cases. Robotic surgery offers the advantages of less scarring and a faster return to regular activity.

Talk with a healthcare professional if you have any concerns or questions about partial nephrectomy. They can help determine the best treatment option for you.