What is a nephrectomy?

A nephrectomy is the surgical removal of a diseased or damaged kidney. A nephrectomy is a treatment for various kidney problems, including kidney cancer and irreversible kidney damage.

Your two kidneys are located on either side of your spinal column just below your ribcage. Your kidneys filter wastes and extra fluids from your blood, make urine, maintain electrolyte balance, help control blood pressure, and make certain hormones and enzymes. 

A nephrectomy is a major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a nephrectomy.

Types of nephrectomy

The types of nephrectomy include:

  • Bilateral nephrectomy is the removal of both kidneys. People with bilateral nephrectomies require dialysis or a kidney transplant to live.
  • Donor nephrectomy is the removal of a healthy kidney from a living donor for the purpose of transplantation.
  • Partial nephrectomy is the removal of only a portion of a diseased or damaged kidney.
  • Simple nephrectomy is the removal of an entire kidney.
  • Radical nephrectomy is the removal of an entire kidney, along with the adrenal gland (gland that sits on top of the kidney), surrounding lymph nodes, and possibly a section of ureter (tube that carries urine from the kidney to the bladder).

Other procedures that may be performed

Doctors sometimes perform a kidney transplant with a nephrectomy. A kidney transplant involves placing a donor kidney in the body to take over the work of severely damaged or diseased kidneys.

Why is a nephrectomy performed?

Your doctor may recommend a nephrectomy to treat certain diseases and conditions of the kidneys. Your doctor may only consider a nephrectomy for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a nephrectomy.

Your doctor may recommend a nephrectomy to treat:

  • Birth defects
  • End-stage kidney failure or irreversible damage from infections, stones, or other kidney diseases
  • Kidney donation
  • Trauma
  • Tumors including both cancerous and non-cancerous tumors and growths
  • Uncontrollable high blood pressure due to kidney problems

Who performs a nephrectomy?

The following specialists perform a nephrectomy:

  • Urologists specialize in diseases and conditions of the urinary tract and the male reproductive organs.
  • Pediatric urologists specialize in diseases and conditions of the urinary tract and male reproductive organs in infants, children and adolescents. 
  • Transplant surgeons specialize in transplant surgery of the kidney, liver, pancreas, and other organs.

How is a nephrectomy performed?

Your nephrectomy will be performed in a hospital. Your doctor will perform your nephrectomy using one of the following approaches:

  • Minimally invasive surgery involves inserting special instruments and an endoscope through small incisions in your abdomen. An endoscope is a thin, lighted instrument with a small camera. The camera transmits pictures of the inside of your body to a video screen viewed by your surgeon while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less damage to tissues and organs. Your surgeon will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery. Minimally invasive surgery may also include the use of a surgical robot or special imaging technologies (computer-assisted surgery) to help your surgeon view the area and perform the surgery.
  • Open surgery involves making an eight to 12 inch incision in your abdomen or side flank area. Open surgery incision allows your surgeon to directly view and access the surgical area. Open surgery requires a larger incision and involves more cutting and displacement of muscle and other tissues. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.