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Nephrectomy - Procedure, Steps, Types & Recovery Time

Medically Reviewed by
Dr. Aman Priya Khanna
Nephrectomy

Treatment Duration

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2.5 Hours

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3 Hours

Treatment Cost

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1,80,000

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5,00,000

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Nephrectomy
Medically Reviewed by Dr. Aman Priya Khanna Written by Sparshi Srivastava

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Our human body primarily relies on bean-shaped organs and kidneys to remove waste. Have you wondered what happens if they stop functioning? Sometimes, a diseased or damaged kidney may require removal. Nephrectomy is one such surgical procedure in modern medicine to remove a problematic kidney. 

This kidney operation is also used in the treatment of cancerous kidney tumours, but that’s not all.  Do you want to learn more? This article discusses the different types of nephrectomy, the recovery process, and everything you need to know.

Procedure Name 

Nephrectomy

Alternative Name 

Kidney removal

Conditions Treated 

  1. Kidney tumours

  2. Damaged kidneys

Benefits of the Procedure 18

  1. Enhanced cancer control

  2. Better quality of life

  3. Improved kidney function

Treated By 

Urological Surgeon

You can check Nephrectomy Cost here.

What is Nephrectomy?

Nephrectomy is derived from two Greek words, 'nephro', meaning kidney, and 'ectomy', meaning removal. This is a surgical procedure designed to extract a kidney or a portion of it. 

A urinary system specialist, called a urologic surgeon, performs this surgery. The technique is often employed to treat renal cell carcinoma, the most common type of kidney cancer in adults.

Anatomy and Physiology of the Kidney

The average adult kidney is about 12 cm long, 6 cm wide, and 3 cm deep. It has roughly 1-1.3 million nephrons (functional units of the kidney). It filters the waste from blood plasma, converts it into urine, and eliminates it from the body. Three layers surround each kidney, offering support and protection:

  1. Renal Fascia: This thin connective tissue layer attaches the kidney to surrounding tissue. 

  2. Adipose Capsule: Also known as perirenal fat, this layer of fatty tissue covers each kidney. It protects the kidney by absorbing any shock.

  3. Renal Capsule: The inner connective layer that safeguards the internal kidney tissue.

Types of Nephrectomy

Understanding nephrectomy options for kidney removal is essential. They can vary depending on the situation. 

The two main types include:

  1. Radical Nephrectomy: This surgery involves removing the entire affected kidney. In some cases, the surgeon might also remove:

  1. Part of the ureter (the tube connecting the kidney to the bladder).
  2. The adrenal gland is located above the kidney.
  3. Some nearby lymph nodes. This is typically done in cases of suspected cancer progression.

  1. Partial Nephrectomy: It is also known as kidney-sparing or nephron-sparing surgery.  This procedure focuses on removing only the diseased or damaged portion of the kidney. This surgery may be performed as follows:

  1. Open Partial Nephrectomy: The surgeon makes a larger incision to access the kidney. 
  2. Laparoscopic/Robotic Partial Nephrectomy: Smaller incisions and specialised tools are used for a minimally invasive approach.

When is a nephrectomy needed?

Kidney removal surgery is a major surgery.  It can be performed at any age; it's often considered for patients experiencing specific kidney issues. Understanding the situations that necessitate this can help in making informed decisions.

Here are some common conditions where nephrectomy can be a valuable solution:

  1. Persistent Infections: If a kidney becomes a recurring source of infections that can't be controlled otherwise.

  2. Diseased or Damaged Kidneys: This can be caused by various factors, including:

  1. Kidney cancer
  2. Congenital disabilities that affect kidney function
  3. Severe infections or complications from kidney stones
  1. Severe Kidney Injury: Some incidents can permanently damage a kidney, necessitating removal.

  2. Potential Kidney Donor: A healthy kidney from a living donor can offer another person a chance to improve their life through a kidney transplant.

Benefits of Nephrectomy

Nephrectomy, or the surgical removal of a kidney, can offer several significant benefits when dealing with various kidney problems:

  1. In cases of CKD (chronic kidney disease), removing the diseased kidney can alleviate symptoms like fatigue, swelling, and difficulty urinating. 

  2. It can also slow the progression of the disease and improve overall kidney function, potentially delaying the need for dialysis or a transplant.

  3. Nephrectomy can eliminate the disease for persistent kidney infections that resist antibiotic treatment.

  4. In kidney cancer or benign tumour cases, a nephrectomy can remove the cancerous or abnormal tissue. 

  5. Potentially cure early-stage kidney cancer and restore the health of the remaining kidney.

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Before and On the Day of Nephrectomy

Preparation is the key to a smooth nephrectomy (kidney removal) procedure. The surgeon will provide detailed instructions to follow the days before and on the day of the surgery.

Before  Nephrectomy

The individual is typically admitted to the hospital a day or two before for pre-surgery monitoring.  This allows the medical team to conduct necessary tests for the procedure. Other preparations are as follows:

Parameter

Pre-requisites

Restrictions

Blood thinners and aspirin should be stopped.

Fasting

12 hours before surgery

Pre-op Assessments 

  1. Blood Tests

  2. Baseline kidney function Blood count

  3. Coagulation Profile 

Risk Evaluation 

Benefits vs Risks

Anaesthesia

General anaesthesia

On the Day of Nephrectomy 

The type of nephrectomy the doctor performs (complete or partial) will determine the length of the surgery. It can take up to 3 hours. Here are some requirements on the day of the procedure:

Parameters

Pre-requisites

Consent 

Necessary

Surgical Preparation 


Shifting from room to the operating room

Physical Evaluation


  1. Check oxygen levels

  2. Heart activity (ECG machine) 

  3. Vital parameters

IV Line

Yes, for drugs and fluids

Patient Position


  1. Slightly tilted position (open nephrectomy)

  2. Lie down on the back (laparoscopic nephrectomy)

Procedure for Kidney Removal Surgery

Regardless of whether the procedure is laparoscopic (minimally invasive) or open, nephrectomies are performed using general anaesthesia. This is to keep the patient comfortable and pain-free. The steps of nephrectomy are as follows:

Laparoscopic Nephrectomy

It is a minimally invasive approach that promotes quicker recovery with less operative pain for patients.

  1. Four cuts are made in the patient's abdomen or side.

  2. A camera (laparoscope) is inserted through one incision. This projects a magnified image of the kidney onto a large screen to visualise the area.

  3. The surgeon removes either the diseased portion of the patient's kidney or the entire kidney itself.

  4. A smaller opening, typically around 8 cm wide, is made in the lower abdomen, below the navel. This allows them to extract the kidney through this dedicated incision.

Open Nephrectomy

Open nephrectomy is a traditional surgical approach. This may be necessary in specific cases. 

  1. A larger incision is made in the patient's abdomen to provide direct access to the kidney.

  2. The surgeon directly removes the diseased part or the entire kidney.

  3. The kidney operation stitches are performed to close the incisions.

After Kidney Operation and Recovery

Once fully awake and stable, the patient will be transferred to the recovery room. Healing begins immediately in the hospital and then continues at home. The following is a general guideline: 

After Nephrectomy 

The hospital stay following a nephrectomy ranges from one to five days. The exact duration depends on the type of nephrectomy performed. During this time, the patient's healthcare team will closely monitor several factors:

  1. Vital signs like blood pressure, heart rate, and breathing will be regularly checked.

  2. Blood tests assess the electrolyte and fluid balance in the body.

  3. A urinary catheter (a hollow tube) drains urine from the bladder for 7 to 10 days. ¹⁹ ²º. However, this number of days can vary depending on the patient’s condition.

  4. Chest physiotherapy exercises are recommended within 24 hours after the surgery to prevent lung infections. These help clear mucus from the lungs and promote deeper breathing.

Recovery in Hospital 

This period is essential for close monitoring and initiating recovery. This is essential to ensuring the body adjusts to the surgery.

  1. On the first day after surgery, the patient will be advised to consume minimal food and fluids, allowing the digestive system time to recover.

  2. Once the bowels function normally, a light diet and fluids will be gradually introduced. The transition can take one to three days.

  3. The medical team will change the dressing on the incision as needed to promote healing and prevent infection.

At-Home Recovery

Following discharge from the hospital, the recovery process continues at home. Here's a general timeframe for what the patient can expect:

  1. Within a week or two of returning home, the patient may be able to resume light activities.

  2. Refraining from heavy lifting or vigorous activities for six weeks is crucial to facilitate adequate healing. 

  3. Following this period, blood tests will likely be required to evaluate the remaining kidney function.

  4. The doctor will provide instructions on the frequency of these tests.

First Follow-Up Appointment  

Regular monitoring of renal function is crucial for individuals with only one kidney following a nephrectomy. Typically, 4 to 6 weeks after discharge, the urology team will schedule an initial follow-up appointment. 

The frequency of subsequent follow-up visits depends on the stage of the patient's cancer at the time of surgery:

  1. If the patient has early-stage kidney cancer, yearly follow-up appointments are common for the first few years after treatment.

  2. For patients with later-stage kidney cancer, doctors may recommend a more intensive monitoring schedule. These follow-up visits may occur every 3-6 months during the initial three years after surgery.

Risks and Complications of Nephrectomy

Like any major surgery, nephrectomy carries some potential complications, although they're uncommon. These include:

  1. General surgical risks like blood loss, heart attack, stroke, and allergic reactions to anaesthesia or medications

  2. Blood clots, particularly in the legs, can travel to the lungs, called pulmonary embolism

  3. Breathing problems

  4. Infections can occur at the incision site

  5. Development of a hernia or bulging of organs through the incision

When to consult a doctor? 

Post-nephrectomy recovery at home requires observation for signs needing a doctor's attention. These situations include:

  1. Changes in urination, such as frequent urination or alterations in urine colour

  2. High blood pressure

  3. Nausea or vomiting

  4. Brain fog, causing difficulty in concentrating

Risks of Delaying Kidney Operation 

Delaying a kidney operation can present various challenges, with potential complications. Below are some of the possible conditions that might arise due to delaying kidney operation.

  1. Renal failure

  2. Local tumour expansion leading to heightened discomfort

  3. Cancer metastasis to the lungs, liver, and bones

Cost of Nephrectomy

The kidney operation cost in India can vary widely depending on several factors. Generally, it starts at ₹1,80,000 and can go up to ₹5,00,000. The average price of the procedure is ₹4,00,000.

Procedure Name

Estimated Cost Range

Nephrectomy

₹1,80,000 to ₹5,00,000

Note: These prices are approximate. Talk to HexaHealth consultants for an updated price. 

  1. Consultation Fee: The initial meeting with the urologist will discuss your health concerns and the suitability of a nephrectomy.

  2. Type of Nephrectomy: The complexity of the surgery plays a major role in cost. A partial nephrectomy is typically less expensive than a radical nephrectomy (removing the whole kidney) and surrounding tissue.

  3. Hospital Choice: Opting for a high-end, well-equipped hospital will likely cost more than a surgical centre with lower overhead costs.

  4. Room Selection: Choosing a private room for post-operative recovery will be more expensive than a shared room. 

  5. Location: Surgeons and hospitals in areas with a higher cost of living might charge more for the procedure.

Takeaway

Nephrectomy can be life-saving for individuals with severe kidney disease or cancer. The surgical approach is individualised and can help prevent severe complications such as renal failure, which can be life-threatening.  

A kidney operation requires the expertise of a highly qualified urologist. HexaHealth can connect you to these experts. We will assist you throughout the treatment process.  Get in touch to book your free consultation!


Frequently Asked Questions (FAQ)

Nephrectomy is a surgical procedure where one or both kidneys are removed. Doctors may recommend this surgery to treat various severe kidney problems like kidney cancer, chronic kidney disease, and severe kidney infection.

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Nephrectomy can be a life-saving procedure for various kidney conditions. However, the specific approach used during surgery may vary depending on the underlying issue. There are two main types:

  1. Radical Nephrectomy: This more extensive procedure involves removing the affected kidney, surrounding fatty tissue, and nearby lymph nodes.

  2. Partial Nephrectomy: In this procedure, only the diseased portion of the kidney is removed, while the healthy tissue is preserved.

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Kidney removal is a major surgery that can be a treatment option for a variety of kidney-related conditions. Nephrectomy indications are thereasons why a doctor might recommend kidney removal. They are as follows:

  1. Kidney cancer

  2. Benign kidney tumours

  3. Chronic kidney disease

  4. Kidney infections

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A nephrectomy costs depend on the hospital, surgeon's expertise, and other factors. Here's a breakdown to give you a general idea:

  1. Starting Range: ₹1,80,000 

  2. Average Cost: ₹4,00,000 

  3. Upper Limit: ₹5,00,000+ 
    Note: The above-mentioned costs are approximate. For accurate pricing, contact Hexahealth.

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Yes, nephrectomy surgery is covered under most health insurance plans. However, the coverage amount may vary depending on the policy. Patients are advised to consult HexaHealth experts for clarifications.

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Understanding the different stages involved can help ease anxiety and also allow for a smooth recovery. After undergoing nephrectomy surgery, here's a general outline of what to expect:

  1. Patients are in the hospital for a couple of days following surgery. This allows doctors to monitor their recovery progress closely.

  2. One will receive instructions on essential aspects of recovery. This includes proper wound care techniques, pain management strategies, and dietary guidelines.

  3. Doctors will schedule regular follow-up appointments to monitor your overall health and kidney function.

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Like any surgery, nephrectomy carries some inherent risks. It is important to understand some potential complications associated with nephrectomy. These include:

  1. Blood loss, allergic reactions to anaesthesia or medications

  2. Pulmonary embolism

  3. Breathing problems

  4. Infections

  5. Injury to nearby organs/tissues

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Recovery typically takes 3-6 weeks, with a hospital stay of up to a week. The doctor will discuss the surgery's success and any follow-up care. They'll also monitor the remaining kidney's function.

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After a nephrectomy, maintain open communication with the doctor. Discuss any issues you have regarding your health, diet, medications, or activities. General healthy lifestyle changes are recommended, which are:

  1. Smoking can significantly worsen kidney function. If you smoke, quitting is one of the best things you can do for your overall health, including your remaining kidney.

  2. Excessive alcohol consumption can have a negative impact on kidney function. Moderate your alcohol intake or abstain completely as your doctor advises.

  3. Chronic stress can have negative health consequences. To manage stress effectively, practice relaxation techniques like meditation or deep breathing.

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The recovery time before a patient returns to normal activities after a partial nephrectomy can vary depending on the surgical approach used. Here's a breakdown:

  1. Open Partial Nephrectomy: Most people can resume normal activities within eight to twelve weeks.

  2. Robotic Partial Nephrectomy: Recovery is generally faster after a robotic partial nephrectomy. Most individuals can start their normal activities within four to six weeks.

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The success rates are generally high for common procedures like nephrectomy (removal of a kidney) or kidney transplant. Approximately 80% of patients maintain satisfactory kidney function after five years of the procedure. 

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Researchers at the University of Texas at Dallas have made a significant discovery about how kidney cells can self-renew.  An article by  Amanda Siegfried, 2023, has shown that kidneys have a surprising ability to repair and maintain themselves throughout life. This ongoing process involves the generation of new cells but to a limited extent.

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Following kidney removal, it's common to experience some pain around the incision site for weeks. This pain may sometimes persist beyond three months after the procedure. 

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Early detection of renal cancer significantly increases the chances of a cure. Surgical intervention, such as a partial nephrectomy, can often be curative in these early stages. In some advanced cases wherein the cancer has spread, curative outcomes become less frequent. 

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No. While we have two kidneys,  humans can function and survive perfectly well with just one. This is because a single healthy kidney can take on the workload of the missing one.  Research suggests that only about 30% of your total kidney function is necessary to maintain normal bodily functions.

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The duration of the hospital stay and overall recovery time depends on overall general health and type of kidney operation. The post-surgical procedures include: A catheter will be inserted after the procedure to drain urine from your bladder for a short period.Instructions regarding dietary restrictions and activity limitations are given.

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For many, nephrectomy has little impact on their long-term well-being. Once fully healed, one can expect to return to everyday activities without limitations. 

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Datta B, Moitra T, Chaudhury DN, Halder B. Analysis of 88 nephrectomies in a rural tertiary care center of India. Saudi Journal of Kidney Diseases and Transplantation: An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia [Internet]. 2012 Mar 1 [cited 2024 May 11];23(2)link
  2. Shroff S. Current trends in kidney transplantation in India. Indian Journal of Urology : IJU : Journal of the Urological Society of India [Internet]. 2016;32(3):173–4. link
  3. Kidney Removal: Reasons, Types, and Benefits [Internet]. Healthline. 2012. link
  4. Mayo Clinic. Nephrectomy (kidney removal) - Mayo Clinic [Internet]. www.mayoclinic.org. 2018. link
  5. Nephrectomy: Surgery Types, What to Expect, Recovery [Internet]. Cleveland Clinic. link
  6. Taylor J. Renal system 1: the anatomy and physiology of the kidneys [Internet]. Nursing Times. 2023. link
  7. Nephrectomy - Types, Risks & Complications [Internet]. Medindia. link
  8. Cancer services [Internet]. [cited 2024 May 11]. link
  9. Kidney Removal (Nephrectomy) Postoperative Instructions [Internet]. The Urology Group of Virginia. [cited 2024 May 11]. link
  10. Partial Nephrectomy: Purpose, Types, Procedure & Recovery [Internet]. Cleveland Clinic. link
  11. Researchers’ Sweeping Discovery Shows How Kidney Cells Self-Renew [Internet]. News Center. link
  12. Long-Term Pain After Nephrectomy: What to Expect [Internet]. Healthline. 2023 [cited 2024 May 11]. link
  13. Why Do We Need Two Kidneys? 11 Kidney Problems, Symptoms, Treatment [Internet]. eMedicineHealth. link
  14. After kidney cancer surgery [Internet]. www.cancerresearchuk.org.link

Last Updated on: 4 July 2024

Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

Reviewer

Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

MBBS, DNB General Surgery, Fellowship in Minimal Access Surgery, FIAGES

12 Years Experience

Dr Aman Priya Khanna is a well-known General Surgeon, Proctologist and Bariatric Surgeon currently associated with HealthFort Clinic, Health First Multispecialty Clinic in Delhi. He has 12 years of experience in General Surgery and worke...View More

Author

Sparshi Srivastava

Sparshi Srivastava

B.Tech Biotechnology (Bansal Institute of Engineering and Technology, Lucknow)

2 Years Experience

An ardent reader, graduated in B.Tech Biotechnology. She was previously associated with medical sciences secondary research and writing. With a keen interest and curiosity-driven approach, she has been able to cont...View More

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