What is nephrectomy?
It’s the medical term for the surgical removal of a kidney.
A partial nephrectomy removes part of the kidney.
A total or radical nephrectomy removes the whole kidney and may also remove surrounding tissues.
Who is nephrectomy for?
Kidney removal may be recommended if you have kidney cancer. Usually, the aim is to cure the cancer by removing the area that contains the tumour but if the cancer has spread, you may still have this operation to help other treatments work better.
Sometimes, a nephrectomy may be performed for other reasons – for example, to remove a diseased or damaged kidney that might become infected.
If you donate a kidney to someone (living kidney donation), you will have a nephrectomy to remove one of your healthy kidneys which will then be transplanted into the recipient.
What does nephrectomy involve?
The operation is carried out under general anaesthetic, so you’ll be asleep throughout.
A keyhole method, also known as laparoscopy, is often used. It uses tiny instruments to remove all or part of the kidney through small cuts in your abdomen, while the surgeon looks at the area with a telescopic camera. Often, a robot controlled by the surgeon operates the instruments to make the procedure as precise as possible.
Sometimes, nephrectomy is carried out by open surgery. This involves removal of all or part of the kidney through a single large incision.
Is it safe? Are there any alternatives?
Any type of surgery under general anaesthetic carries some risks but these are usually small.
Generally, nephrectomy is a safe procedure, and the benefits are likely to outweigh any risks. The keyhole method has a lower risk of complications and a shorter recovery time, and open nephrectomy is usually only used in complex cases, or when the kidney is very large. Occasionally, the surgeon may need to switch from keyhole to open surgery during the procedure, for example, if there’s a lot of bleeding.
Side effects and complications may include:
- shoulder tip pain and abdominal bloating. This is common with the keyhole method as gas is used to inflate the abdominal cavity (your stomach area)
- bleeding. You may need a blood transfusion if you bleed a lot.
- infection in one of the incision sites. You’ll be given antibiotics to help prevent this.
- a hernia in an incision which will need further treatment.
- damage to the lung cavity, nearby organs or blood vessels. This is rare but can be repaired if it occurs, although it may sometimes require further surgery
- serious complications such as blood clots. These are very rare but can potentially occur in many types of surgery.
Where will the nephrectomy take place?
The operation will be carried out in hospital.
It will be performed by a surgeon, supported by a team of other doctors and nurses, including an anaesthetist.
What happens before the procedure?
- You’ll have a pre-assessment before the operation to check your fitness for surgery.
- You’ll be asked about your medication and overall health, and you may have some further investigations including blood tests, a chest X-ray and an ECG (electrocardiogram), a test that records the electrical activity of your heart.
- You can ask any questions you have.
- You won’t be able to eat or drink for some hours before having the anaesthetic. Your hospital team will tell you how long this will be.
- You’ll also be told if you need to stop any of your usual medications before the procedure.
What happens during a nephrectomy?
- When you’re admitted to hospital, you’ll be asked to wear anti-thrombosis stockings to help prevent blood clots in your legs.
- You’ll be seen by different members of the surgical team, including the anaesthetist, who may give you some medication that makes you feel relaxed.
- Once you’re taken to the operating theatre, you’ll be given anaesthetic that makes you go to sleep.
- In keyhole surgery, three or four small cuts will be made. A laparoscope (a thin tube with a light and camera on the end) will be inserted.
- The camera sends pictures to a screen so the surgeon can see the kidney and surrounding area.
- Gas will be used to inflate the abdominal cavity so the structures can be seen more easily. Using tiny instruments, which may be operated by a robot for precision, the surgeon will carefully disconnect the kidney and any other tissues that need to be removed. They will then take the kidney out through one of the cuts.
- In open surgery, one larger incision will be made to remove the kidney.
- The procedure will take around 2-4 hours.
What happens immediately after the procedure?
You’ll be taken to the recovery room, where you’ll gradually wake up from the anaesthetic. You may have a drip into your arm for fluids, along with a bladder catheter and an oxygen mask or nasal prongs if you need extra oxygen. You may also have a drain (tube) to drain blood and fluid. This is more common with open nephrectomy.
Staff will monitor you and provide fluids and medication such as pain relief if needed. When you’re ready, you’ll be taken back to the ward, where staff will continue to monitor you. You’ll be encouraged to eat, drink and start to move.
The time spent in hospital varies but the average is around three days. You’ll be discharged when staff are happy that you’re safe to go home.
What should I expect when I get home?
Recovery time varies. Many people can get back to their usual activities after about four weeks, but full recovery may take up to 12 weeks. During this time, you should avoid heavy lifting and strenuous activities.
It’s normal to have some discomfort in the incision sites for a few weeks. This can usually be managed with paracetamol.
You’ll be told how to look out for signs of complications like infection, such as a temperature and increasing redness. Contact your GP or the hospital team if you notice these.
How will I get the results?
You’ll have a follow-up appointment several weeks after the operation. At this appointment, you’ll be told the results of tests on the kidney or the section of kidney that was removed if you had the nephrectomy because of damage to your kidneys.
If you had a nephrectomy because you donated a kidney to a stranger (non-directed donation), you may be told whether the transplant was a success. However, as such donations are anonymous, your recipient may not wish to share any further information with you.
Is there anything else I need to know?
You’ll need someone at home with you for the first 24 hours after discharge.
You won’t be able to drive for a few weeks after the operation.
You will need some time off work after having this operation. Most people return to work after a few weeks, but this depends on what job you do. You may need longer off work if you have a manual job or one that involves heavy lifting.
You will be able to resume sexual activity when you feel comfortable to do so but you may wish to wait 4-6 weeks to allow time to heal.
Publication date: 02/2026
Review date: 02/2029