Nephrectomy

Nephrectomy is surgery to remove part or all of a kidney. Partial nephrectomy preserves part of the kidney; radical nephrectomy removes the whole kidney. These are different treatment choices, not interchangeable names for the same operation. Robot-assisted partial nephrectomy is one way of carrying out kidney-preserving surgery. The decision about how much kidney to remove is separate from the choice of surgical equipment.

Kidney-preserving surgery is an established option for very early-stage kidney cancer. For localized kidney cancer, thermal ablation—destroying the tumour through a probe placed through the skin—is another option, particularly for people who are not fit for surgery. It is not automatically interchangeable with partial nephrectomy.

Cancer that has already spread elsewhere requires a different discussion. For people with clear-cell kidney cancer that was metastatic at diagnosis, classified as intermediate or poor risk, and requiring drug treatment, the 2018 recommendation was not to use immediate removal of the kidney tumour routinely before drug treatment. This is a specific treatment setting, not a reason to rule out kidney surgery for everyone with cancer.

For kidney tumours classified as pT2 after examination of the removed tissue, a 2026 analysis of seven studies involving 2,715 patients found no statistically significant difference between partial and radical nephrectomy in survival without death from kidney cancer at two or five years. The partial-nephrectomy group had smaller tumours, so this comparison does not prove that both operations work equally well for every patient.

Short-term kidney function has also been compared between robotic systems used for partial nephrectomy. In four studies involving 405 people with early-stage kidney cancer, there was no statistically significant difference between the MP1000 and da Vinci systems in estimated kidney filtering function at two days or four weeks after surgery. These are early kidney-function results, not a measure of long-term cancer cure.

Bleeding, the need for a blood transfusion and urine leakage are risks considered in research on partial nephrectomy. The position of the tumour also matters. In eight studies involving 7,064 people undergoing robot-assisted partial nephrectomy, 1,292 had tumours at the kidney’s central junction, called the hilum, and 5,772 had more peripheral tumours. Surgery for central tumours was associated with greater blood loss during the operation, a higher need for transfusion and more severe complications around the time of surgery. These findings concern that particular comparison; they do not give an individual’s absolute complication risk.

The number of access ports used for robotic partial nephrectomy may affect some aspects of early recovery, but comparisons are not consistent. A 2026 analysis of 15 studies involving 2,689 patients—902 treated with a single-port approach and 1,787 with a multi-port approach—found an average hospital stay 0.43 days shorter with the single-port approach. Most studies were retrospective, meaning they looked back at previous treatment. A separate 2026 analysis limited mainly to less complex tumours, involving 442 patients in three studies, found no clear difference in hospital stay. A difference between groups is not a predicted discharge date for an individual patient.