Kidney Cancer Surgery

Kidney cancer (renal cell carcinoma) develops in the kidneys, a pair of vital organs that remove waste and excess fluid from the blood. The cancer begins when cells in the blood-filtering tubules undergo harmful changes that cause them to grow uncontrollably and form tumors. While the exact cause of the cellular DNA mutations is unclear, factors such as smoking, obesity and high blood pressure may increase the risk.

Kidney cancer is relatively common, particularly among adults 60 and older. Symptoms include blood in the urine, persistent back or side pain and unexplained weight loss. Although treatment can vary depending on the type and stage of the tumor, surgical intervention is the primary approach for many patients. Surgery may be followed by radiation therapy, chemotherapy or immunotherapy to help prevent cancer recurrence.

Surgical treatment options for kidney cancer may include:

Partial nephrectomy surgery for kidney cancer

Partial nephrectomy involves removing a cancerous tumor or abnormal tissue from a kidney while preserving as much healthy kidney tissue as possible. This procedure may be considered to address a small kidney tumor. It may also be suitable for a patient with existing kidney disease or only one functioning kidney, making it a priority to maintain kidney function.

When performing partial nephrectomy surgery, the surgeon will remove the kidney tumor along with a small margin of surrounding healthy tissue. The removed tissue will then be sent to a laboratory for microscopic examination by a pathologist to help ensure that all cancerous cells were eliminated.

The types of partial nephrectomy include:

• Open partial nephrectomy – After making a standard incision in the flank or abdomen, the surgeon will gain direct access to the affected kidney. This traditional surgical approach may be used in complex cases or when precise control of the surgical area is required.
• Laparoscopic partial nephrectomy – During this minimally invasive procedure, the surgeon will make a few tiny incisions and insert a miniature camera and specialized surgical instruments. Guided by real-time imaging, the surgeon can operate with heightened accuracy.
• Robotic-assisted partial nephrectomy – When performing this advanced surgical technique, the surgeon will use robotic technology, such as the da Vinci Robotic Surgical System, for enhanced precision and dexterity.

How to prepare for partial nephrectomy surgery for kidney cancer

Preparing for partial nephrectomy surgery involves several steps to ensure a safe and successful procedure. The patient will meet with the surgical team in advance to discuss their medical history, including medication use and any underlying health issues. The surgeon will provide specific instructions, which may include pausing certain medications, following a fasting protocol the night before and arranging for assistance at home during recovery. Preoperative testing, such as blood work and imaging, may be performed to evaluate the patient’s kidney function and overall health.

What to expect after partial nephrectomy surgery for kidney cancer

After partial nephrectomy surgery, the patient can expect to stay in the hospital for a few days for monitoring during the initial phase of recovery. Pain or discomfort at the surgical site is common and can usually be managed with medication. The patient will gradually resume eating and moving with guidance from their healthcare team. Follow-up appointments will be scheduled to monitor kidney function and ensure healing. Most patients can return to their normal activities within a few weeks with some restrictions on heavy lifting and strenuous activity.

What are the risks and potential complications of partial nephrectomy surgery for kidney cancer?

Like any surgical procedure, partial nephrectomy surgery carries some risks and potential complications. These include excessive bleeding, infection, blood clots and injury to surrounding organs and tissues, such as the bowel and spleen. Some patients experience decreased kidney function or, in rare cases, the need for dialysis if the remaining kidney tissue cannot function adequately. Long-term complications may involve scarring or issues related to the surgical incision, such as hernia formation.

Radical nephrectomy surgery for kidney cancer

Radical nephrectomy surgery involves removing the entire cancerous kidney along with the attached adrenal gland, some nearby lymph nodes and portions of surrounding structures, such as fatty tissues, to help ensure complete tumor removal. This procedure may be considered if the tumor is large, has spread beyond the kidney or cannot be treated effectively with partial nephrectomy surgery.

Depending on the specifics of the case, the procedure may be performed as:

• Open radical nephrectomy – This traditional surgical approach involves a large abdominal incision, allowing the surgeon to directly access and precisely remove the cancerous kidney and surrounding tissues.
• Laparoscopic radical nephrectomy – When performing this minimally invasive technique, the surgeon makes small incisions and uses a camera-equipped surgical instrument (laparoscope) to remove the cancerous kidney. Typically, laparoscopic surgery results in a shorter recovery, minimal scarring and less postoperative pain than open surgery.
• Robotic-assisted radical nephrectomy – This technologically advanced form of laparoscopic surgery involves the use of a robotic system that provides the surgeon with enhanced precision and control.
• Robotic-assisted nephroureterectomy – More extensive than a standard radical nephrectomy, this procedure may be considered if cancer is present in both the kidney and the ureter (upper tract urothelial carcinoma). The surgeon will remove the entire kidney, ureter and sometimes the portion of the bladder where the ureter connects.

How to prepare for radical nephrectomy surgery for kidney cancer

To prepare for radical nephrectomy surgery, the patient should follow their surgeon's instructions carefully. Typically, this will include undergoing preoperative testing, such as blood work, imaging and possibly an electrocardiogram, for an overall health assessment. The patient may need to stop taking certain medications, such as blood thinners, and should avoid eating or drinking for a specified period before the procedure. They will also need to arrange for transportation home and assistance during recovery. Discussing any questions or concerns with the surgical team can help the patient feel more confident and informed.

What to expect after radical nephrectomy surgery for kidney cancer

After radical nephrectomy surgery, the patient can expect a hospital stay of a few days for monitoring and pain management. Initially, there may be some discomfort at the surgical site, which can usually be managed with prescribed medications. The patient will gradually transition from bed rest to light activity to promote healing and prevent complications. A follow-up appointment will be scheduled to monitor recovery and discuss pathology results. Full recovery can take up to several weeks, and the patient will be advised to avoid heavy lifting and strenuous activities during this time. The remaining kidney will usually take over most of the functions of the removed kidney.

What are the risks and potential complications of radical nephrectomy surgery for kidney cancer?

Radical nephrectomy surgery carries certain risks and potential complications, including bleeding, infection and blood clots, which may require prompt treatment. There is also a chance of injury to nearby organs, such as the spleen, liver and bowel. While the remaining kidney typically compensates for the removed kidney, some patients experience reduced kidney function. Other possible complications include hernia formation at the incision site and rare anesthesia-related issues, such as allergic reactions and breathing difficulties. The surgeon will discuss these risks beforehand and take appropriate precautions to minimize them.

Arterial embolization surgery for kidney cancer

Arterial embolization is a minimally invasive procedure that can be used to treat kidney cancer, either as a supportive measure or a presurgical step to reduce blood loss during a nephrectomy. It involves blocking the blood supply to the kidney tumor to shrink it and limit its growth. This is achieved by inserting a catheter into the artery that supplies the kidney and delivering embolic agents, such as small particles or coils, to obstruct blood flow.

While not a curative treatment, arterial embolization can be effective in managing kidney cancer symptoms, such as pain and bleeding. It may also be suitable for a patient who is not a candidate for surgery due to other health issues. The procedure is typically performed by an interventional radiologist under local anesthesia and sedation.

How to prepare for arterial embolization surgery for kidney cancer

To prepare for arterial embolization, the patient will typically undergo imaging tests, such as computed tomography (CT) or magnetic resonance imaging (MRI scans), to help the physician assess the tumor and map the blood vessels. After reviewing the patient’s medical history and medications, the physician may advise the patient to temporarily stop taking blood thinners or other drugs before the procedure. In most cases, fasting for several hours beforehand is required. The patient should also arrange for someone to drive them home afterward and help with their recovery.

What to expect after arterial embolization surgery for kidney cancer

After arterial embolization, the patient can expect to remain in the hospital for observation, typically for a day or two. Mild discomfort at the catheter insertion site and fatigue are common. Some patients also experience low-grade fever or nausea, which usually resolves with supportive care. The treated kidney tumor may shrink over time, and follow-up imaging will be scheduled to monitor the results. Compared to more invasive procedures, recovery from arterial embolization is typically faster, but the patient should still avoid strenuous activity for several days and follow their physician’s post-procedure care instructions closely.

What are the risks and potential complications of arterial embolization surgery for kidney cancer?

Arterial embolization is generally safe, but as with any procedure, it carries some risks. Potential complications include bleeding and infection at the catheter insertion site, damage to surrounding blood vessels and kidney tissue injury. Some patients also experience post-embolization syndrome—characterized by fever, pain and nausea—which typically resolves with medication and rest. Rarely, unintended embolization of nontargeted areas may occur, potentially affecting nearby organs. Close monitoring and follow-up care can help minimize and manage these risks.

What is recovery from kidney cancer surgery like?

The recovery period that follows kidney cancer surgery can be influenced by several factors, including the type of procedure performed and the patient’s overall health. Therefore, the surgeon who performed the procedure is the best source of information about what to expect.

In general, immediately after surgery, the treatment team will check in with the patient regularly to monitor the healing of their incision and help keep them comfortable. The patient will likely be instructed to resume eating solid foods within 24 to 48 hours, which is important because proper nutrition can help the body heal. During this time, the patient will be transitioned to oral pain medication.

After spending one to four nights in the hospital, the patient will be discharged so they can continue to recover in the comfort of their own home. A follow-up appointment will likely be scheduled within two to four weeks. At that time, the surgeon will explain when to return to work and resume other activities.

Because physical activity can promote blood circulation and decrease the risk of blood clots, the treatment team will likely encourage the patient to exercise throughout their recovery from kidney cancer surgery. Soon after the procedure, the patient will be helped out of bed and can begin some light walking with assistance. Initially, there may be some discomfort, which should gradually improve with time.

Services and features at Moffitt McKinley Hospital include:

• Surgery operating and recovery rooms
• Radiology/diagnostic imaging
• Pathology and laboratory
• Publix Pharmacy
• Ancillary clinical services
• Patient and Family Center
• Café and cafeteria
• Gift shop

Benefit from world-class care at Moffitt Cancer Center

Kidney cancer patients can receive world-class care at Moffitt, where we take a unique, multispecialty approach to ensure that each patient receives the benefit of several expert opinions. We also offer promising new surgical techniques and other treatment options through our robust portfolio of clinical trials. Surgical candidates can have peace of mind in knowing that Moffitt’s experienced, fellowship-trained surgeons have helped thousands of patients fight cancer and achieve the best possible quality of life.

If you would like to learn more about kidney cancer surgery, you can request an appointment with a specialist in the Urologic Oncology Program at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.