Having a kidney removed

This leaflet explains the operation to have a kidney removed. This is sometimes called a ‘radical nephrectomy’. 

This surgery is usually done for kidney cancer. It may include removing tissue surrounding the kidney and part of the tube between the kidney and the bladder. 

The operation usually takes 2 to 4 hours.

It is carried out under a general anaesthetic. This means you will be asleep throughout. 

We will give you more information about the anaesthetic at your pre-operative assessment appointment.

About robot-assisted surgery

The operation is carried out using keyhole (laparoscopic) surgery with robotic assistance. 

Keyhole surgery means a telescope and other instruments are inserted into the body through small cuts instead of one large cut.  

Robot-assisted surgery means the surgeon uses the robot to help perform the procedure. The robot does not operate by itself. It allows the surgeon to make more precise movements and do more complex surgery.

Read our leaflet to learn more about robot-assisted surgery and why a robot is used.

Benefits of this type of surgery 

Traditional surgery to remove a kidney needs a cut in the abdomen up to 30cm long. Keyhole surgery uses only a few small cuts about the size of your fingertip.

Because of this, robot-assisted keyhole surgery has lots of benefits compared to traditional ‘open’ surgery. You are likely to return to normal activities sooner after keyhole surgery. Typically, this can range from 4 to 6 weeks. Most patients go home the day after surgery or within 1 to 3 days. 

Other benefits of keyhole surgery include:

  • smaller scars
  • less blood loss
  • lower risk of infection
  • less pain
  • faster recovery
  • lower risk of wound complications, such as hernia.

What to expect

Before your operation

A few weeks before surgery, you will have an appointment with the surgical doctors. They will explain the procedure and discuss the benefits and risks. 

One to two weeks before your operation, you will have a pre-operative assessment. This may include blood tests, heart checks and other tests. If you have other significant medical conditions, you may be seen by a consultant anaesthetist for more detailed checks.

On the day of surgery

On the day of surgery, you should come to our ‘Admissions on the Day’ unit at Kingston hospital. For more information, go to our leaflet on admission for surgery. If you have other health problems we may admit you the evening before surgery.

The anaesthetist will see you on the morning of surgery. The surgical team will also see you to obtain your consent for surgery and mark the correct side for surgery.

After the operation (in hospital)

After surgery, you may spend one night in a high dependency unit, if needed.

You might have:

  • oxygen tubing in your nose
  • a drip in your arm
  • a wound drain to remove excess blood and fluid (usually removed after one day)
  • a catheter to drain your bladder (usually removed after one day).

Eating and drinking

We will give you instructions about eating and drinking after your surgery. It is likely we will encourage you to drink and eat as you feel able. Some people start with fluids before moving on to solid food. 

Pain

You may feel mild pain, swelling or bruising around the surgery cuts. 

You may get shoulder pain due to the gas used to inflate the abdomen during surgery. Your abdomen may feel bloated or uncomfortable. These symptoms usually settle within a few days.

Getting moving

Nurses or physiotherapists will help you to get out of bed and move around. If possible, this should be first thing in the morning the day after your surgery. Gentle movement helps reduce complications and speeds recovery.

Going home

Most patients go home 1 to 3 days after surgery, depending on their recovery. 

You may have stitches that dissolve or wound clips. If you have clips, you will need to arrange for your practice nurse to remove them 10 to 14 days after surgery. 

We will send you details of any follow-up appointments or scans.

Recovery at home

Pain is often worst between day 2 and day 4 after the operation. Before you leave hospital, we will tell you what pain relief we recommend. 

It is common to feel tired for up to two months.

Constipation is common. We will give you medicines (laxatives) to use when needed.

We recommend gentle walking and light exercise. This reduces your risk of complications and helps recovery. Avoid heavy lifting, gym work, running, cycling or swimming for 3 to 4 weeks.

Do not drive for 2 to 4 weeks. Only drive when you are not limited by pain and can react quickly to do an emergency stop.

Shower rather than bathe for the first week. Keep wounds clean and dry. 

Check your wounds for signs of infection, such as redness, swelling, pain or discharge.

Contact your GP, district nurse or hospital team if you have any concerns.

Risks of this operation

Risks during or shortly after surgery

More common
More than 15 in 300 patients
  • Switch from keyhole to open surgery during the operation. This might be done to control bleeding, repair intestinal injury or due to an inability to complete the operation in the keyhole way. The risk of this being required is higher in those who are obese or have had previous surgery in the area.
Less common
Fewer than 15 in 300 patients
  • Significant bleeding caused by injury to blood vessels, liver or spleen. A blood transfusion or further emergency treatment might be required.
  • Damage to the bowel, liver, pancreas, spleen, lungs or major blood vessels.
Rare
Fewer than 3 in 300
  • Complications during or immediately after the operation, such as infection, blood clots, heart problems, stroke, memory problems or kidney problems. These may mean you need to stay in hospital for longer or need extra treatment.

Risks after surgery

Common
More than 15 in 300 patients
  • Abdominal and shoulder tip discomfort is expected for a few days or weeks.
  • Bloating of the abdomen and slowing of the bowel and constipation - this usually resolves within a few days.
Less common
Fewer than 15 in 300 patients
  • Wound infection. This may need treatment, such as antibiotics.
  • Further treatment due to complications after the operation or because of the cancer.
  • Hernia caused by the abdominal muscles being weakened by the surgery wound. Tissue, such as bowel, may bulge through. Sometimes, surgery is needed to correct this.
  • Long-term pain.
Rare
Fewer than 3 in 300
  • Tests on the removed kidney show that your diagnosis was wrong and you do not have cancer.
  • The remaining kidney does not work well enough and you need dialysis to remove waste and fluid from your blood.
  • Blood clots. Wearing compression stockings and getting moving early reduces your risk of clots. Blood thinning injections may also be used depending on your treatment and medical history.
Rare
1 in 300
  • Death caused by the surgery or because of complications afterwards.
  • Cancer returns either in the same area or somewhere else in the body.

More information

You may find the following organisations helpful:

Kidney Cancer UK 

Cancer Research UK