Kidney Cancer Surgery (Partial Nephrectomy)

What happens during minimally invasive kidney cancer surgery?

A nephrectomy can be performed with open surgery or using minimally invasive techniques, such as laparoscopic or robotic surgery. Less invasive approaches involve small incisions and advanced instruments, compared to open surgery which involves one long incision in the belly.

• A laparoscopic nephrectomy involves several small incisions in the abdomen. Through these incisions, your surgeon will use long instruments, including a laparoscope, or thin lighted tube with a camera on the end, to remove the cancerous part of the kidney (partial nephrectomy) or all of the kidney (radical nephrectomy).

• A robotic nephrectomy, or robotic-assisted nephrectomy, allows your surgeon to operate with exceptional precision using robotic assistance. It mirrors the same tiny incisions used in a laparoscopic procedure. Then, your surgeon uses an advanced robotic system, the da Vinci Surgical System, with specialized instruments and a 3D camera mounted on robotic arms to operate with a greater range of motion than the human hand alone. Robotic assistance offers numerous benefits for patients, enhancing your surgeon’s ability to be precise and effective in suturing (stitching).

Minimally invasive nephrectomies are associated with shorter hospital stays, less blood loss, less pain after surgery, and quicker recoveries, compared to open surgery. Your eligibility for minimally invasive kidney cancer surgery will vary based on the size, location, and stage of your tumor, as well as your medical history and goals.

Benefits of minimally invasive kidney cancer surgery

Compared to open surgery, laparoscopic and robotic nephrectomies offer numerous advantages for patients. Because they use smaller incisions than open surgery and require no damage to muscle or bones, patients benefit from:

• Shorter hospital stays
• Less pain and scarring
• Fewer risks of complications
• Faster recoveries

Other types of kidney cancer surgery

There are several different types of kidney cancer surgery, in addition to minimally invasive surgery. Your doctor will discuss which surgical option will be best suited for your unique situation.

Open radical or partial nephrectomy (Open kidney cancer surgery)

While partial and complete kidney removal surgeries can be performed using minimally invasive approaches, sometimes they require open surgery. Open surgery involves one, standard incision on the abdomen, through which your surgeon will remove part of the kidney (partial nephrectomy) or all of the kidney (radical nephrectomy). Our urologic oncologists are highly experienced in performing open partial or radical nephrectomies when certain medical conditions or a tumor’s location, size, or complexity make it difficult to remove with minimally invasive techniques.

Robotic nephrectomy with IVC thrombectomy (Surgery for kidney cancer invading the inferior vena cava)

A small percentage of patients with kidney cancer have large tumors that grow into the veins that drain the kidney and carry blood back to the heart (the inferior vena cava, or IVC). When cancer grows into the IVC, removing a kidney tumor becomes more complex and requires an additional set of skills.

Our MedStar Health urologic oncologists are among less than one percent of surgeons in the country who are highly experienced in treating kidney cancer invading the vena cava using robotic surgery. These intricate procedures often involve a multidisciplinary team, which leads to the best possible outcomes for our patients. We work alongside vascular surgeons, liver surgeons, and/or cardiac surgeons to safely and effectively remove these tumors. In addition, our intensive care units and nursing staff are equipped and trained to care for these patients, ensuring they have the specialized support necessary for recovery.

Recovery after kidney cancer surgery

Many patients who undergo laparoscopic or robotic kidney cancer surgery stay in the hospital for one night, on average. We encourage patients to get moving as soon as possible after surgery, which aids in recovery and is necessary for discharge from the hospital. After you return home, here’s what you can expect.

• Bathing: You can shower 48 hours after surgery. Do not apply soap directly to your incisions. Simply let water run over your incisions. When finished, pat the incisions dry with a towel, but do not scrub. Avoid submerging the incisions in a bathtub or pool for six weeks.
• Diet: Eat a well-balanced diet with plenty of protein, fruits, and vegetables. It may take several weeks to resume your regular diet; eat slowly and avoid overeating, especially immediately after surgery. Avoid alcohol, as this is irritating to your bladder. Eat a diet that you find satisfying and palatable.
• Fluids: It is essential to remain hydrated after surgery. Monitor the color of your urine: it should be as clear as water or light yellow. If it is dark yellow or light red, you should drink more water.
• Constipation: It is very common to have constipation after surgery. It is important to avoid constipation and not to strain during bowel movements. If you become constipated, Colace or Miralax powder can be purchased over the counter at pharmacies. Please use as directed.
• Incision care: Do not rub, pick at, or apply lotion to the incisions until they have healed. If you notice drainage of clear fluid from the incision, please apply a Band-Aid. If you notice the incision is draining blood or pus, or if the area around the incision becomes very red/painful, please call your doctor’s office.
• Driving: Driving is usually permitted after the catheter is removed if you feel comfortable, are taking no narcotic pain medication, and can twist your torso quickly to look over your shoulder without pain.
• Exercise: Light exercises such as walking, jogging, and stretching should be done once you return home. You may safely climb stairs as tolerated. At home, sitting in a recliner/sofa with your feet elevated may help decrease strain on your incisions.
• Lifting: Do not lift anything more than 10 pounds for six weeks. Heavy abdominal exercise, such as sit-ups as well as cycling on an upright bicycle, should be avoided for six weeks.
• Blood in the urine: It is normal for your urine to be pink/light red following surgery. If you notice significant amounts of bright red blood or clots in your urine, or you have significant concerns, please call us immediately.
• Follow-up care: We will follow up with any pathology report findings after your surgery. We will also establish a plan for follow-up visits based on your risk of cancer recurrence.