Surgery for kidney cancer

This is the most common operation for kidney cancers smaller than 4cm. But you may have it if you have a larger kidney cancer. Your doctor will explain if it is suitable for you.

During the operation, the surgeon removes the part of the kidney with the cancer. The aim is to remove the cancer but to leave as much normal tissue as possible. This is so the kidney can continue to work.

You may have this operation if it is important to try to keep the affected kidney. This may be because:

• your other kidney does not work well
• you have kidney disease
• you have other conditions that might affect how well your kidneys work in the future.

If you have an inherited type of kidney cancer, you may be offered this operation. This is because there is a risk you may develop a cancer in the other kidney.

You are likely to be referred to a specialist hospital for this type of surgery. This may mean you have to travel for treatment.

Your doctors may talk to you about an operation to remove the kidney even if the cancer has spread. It will not cure the cancer, but in some people, it can mean that they are likely to live longer. Your treatment plan will usually include other treatments such as immunotherapy and targeted therapy.

You may need to consider the possible advantages of having the kidney removed, as well as the effects of having a big operation. Your doctors will talk to you about the possible benefits and disadvantages.

There are different ways a surgeon can operate on the kidney. Your surgeon will explain how they will do your operation and answer any questions you have. For kidney cancer surgery, you usually have a general anaesthetic.

Kidney cancer surgery is commonly done as keyhole surgery, but open surgery is sometimes needed.

During keyhole surgery, the surgeon uses a laparoscope to see and work inside the tummy (abdomen). A laparoscope is a thin tube with a light and camera on the end. It sends video images to a monitor.

The surgeon starts by making 3 or 4 small cuts in the tummy. They then put the laparoscope through one of the small cuts in the skin. Your tummy will be inflated with gas to help the surgeon operate more easily.

During the operation, the surgeon puts the kidney they want to remove into a bag inside your body. At the end of the operation, they either make one of the cuts bigger, or they make an extra cut. This is so they can remove the bag with the kidney inside.

The position of the cuts depends on who is having the surgery and how the surgeon does the operation. Your surgeon can talk to you about what to expect. Recovery from keyhole surgery is usually quicker than from open surgery. This is because the wounds are smaller.

The surgeon may use a specialised machine to help with keyhole surgery. There are instruments attached to the machine, which the surgeon controls. This is called robot-assisted surgery. The robot makes it possible for the surgeon to move in a very precise way to do complicated keyhole surgery.

During open surgery, the surgeon makes one large cut (incision) just under the bottom rib or between the 2 bottom ribs. This cut can be up to 30cm long. After the operation, the surgeon stitches or staples the wound closed.

Your recovery after surgery will depend on the type of operation you have.

The most common complications after surgery are:

• a wound infection
• bleeding
• a chest infection
• a blood clot.

The nurses will monitor you for these. Tell them straight away if you:

• feel unwell
• have any bleeding
• notice swelling and redness in a limb (arm or leg).

You should also tell them if you have symptoms of an infection, such as a cough or a leaking wound.

You will be given a telephone number to call if you need advice when you get home.

After open surgery to the kidney, some people develop a bulge (swelling) along their scar. Doctors call this an incisional hernia. It can happen because of weakness in the muscles around the scar. Tell your doctor or nurse if you develop a bulge around the scar.

We have more information about general complications after surgery.

How long you stay in hospital depends on the type of operation you have and how quickly you recover:

• After keyhole surgery, most people go home after 2 to 5 days.
• After open surgery, most people go home after 5 to 7 days.

Your body uses a lot of energy to heal. It is common to feel more tired than usual for about 6 weeks after the operation. Most people feel fully recovered after about 12 weeks.

Your surgeon or nurse can tell you when you will be able to get back to doing everyday activities such as shopping, driving, having sex, playing sport or going to work.

Before you leave hospital, you will be given an appointment for a check-up. This is usually about 6 weeks after your operation. It will be at an outpatient clinic. The appointment is a good time to talk about any problems you have after your operation.