Nephrectomy Surgery: Procedure, Types, and Recovery Explained

A nephrectomy surgery — the removal of a kidney — is usually needed only in serious or unavoidable medical conditions.

1. Kidney Cancer
2. Severely Damaged Kidney
3. Chronic Kidney Infection
4. Uncontrolled High Blood Pressure (Renovascular Hypertension)
5. Congenital Kidney Abnormalities
6. Living Kidney Donation
7. Severe Trauma

Nephrectomy Surgery – Step-by-Step Procedure

1. Preoperative Preparation
Patient is admitted and evaluated.
Imaging (CT scan, MRI) confirms the need for kidney removal.
Anesthesia team reviews and prepares the patient.
Patient fasts for 6–8 hours before surgery.

2. General Anesthesia
Patient is put to sleep completely.
A breathing tube is placed to support breathing during surgery.

3. Patient Positioning
The patient is usually placed in a side-lying position (flank position), depending on which kidney is being removed.
The area is sterilized and draped for surgery.
4. Surgical Incision
There are two types of approaches:
a) Laparoscopic Nephrectomy (Minimally Invasive)
3 to 4 small cuts are made.
A camera and surgical instruments are inserted through the cuts.
Gas (CO₂) inflates the abdomen to improve visibility.

b) Open Nephrectomy
A larger cut (10–20 cm) is made on the side or abdomen, or back.
Used for large tumors, complex cases, or trauma.

5. Dissection and Removal
The surgeon carefully separates the kidney from:
Fat and surrounding tissues
Renal artery and vein (blood vessels)
Ureter (urine tube)
Blood vessels and ureter are clamped, cut, and sealed.

6. Kidney Removal
In radical nephrectomy: the entire kidney (plus adrenal gland and surrounding fat, if needed) is removed.
In partial nephrectomy: only the diseased part of the kidney is removed.
In laparoscopic cases, the kidney is placed in a specimen retrieval bag and removed through one incision.

7. Closure
Bleeding is checked and controlled.
A drain tube may be placed.
All incisions are closed with stitches or surgical staples.
A sterile dressing is applied.

8. Recovery

Patient is monitored in recovery room.
Pain medications and IV fluids given.
Urinary catheter usually placed temporarily.
Gradual return to eating, walking, and normal activities.
Discharge in 2–5 days (laparoscopic) or up to 7 days (open surgery).

Kidney stones are a common and painful condition that affect many people. If you’ve been diagnosed with kidney stones and your doctor recommends surgery, you may wonder what happens during the procedure. Urology is the medical field that focuses on the urinary system, including the kidneys, bladder, and ureters, and urologists are the specialists who treat kidney stones. In this blog, we’ll explain the basics of urology and what happens during stone surgery.
Why Do Kidney Stones Require Surgery?

Kidney stones form when minerals and salts in the urine crystallize into hard stones. While small stones can often pass naturally, larger stones or those causing symptoms like severe pain, infection, or urine blockage may require surgical treatment. Surgery is also considered if stones are recurring or if other treatments haven’t worked.

Types of Stone Surgery

Urologists use different methods to remove kidney stones, depending on their size and location. Here are the most common types of surgery:

1. Shock Wave Lithotripsy (SWL)
This non-invasive procedure uses sound waves to break the stone into smaller pieces that can pass through urine. It’s usually for smaller stones in the kidney.
What to expect: This procedure is done under sedation. You may pass fragments of the stone afterward.

2. Ureteroscopy
In ureteroscopy, a small, flexible tube is inserted through the urethra, bladder, and into the ureter (the tube connecting the kidney to the bladder). The stone can be removed or broken into smaller pieces with a laser.
What to expect: It’s done under general anesthesia, and you may need a temporary stent to help with urine flow during recovery.

3. Percutaneous Nephrolithotomy (PCNL)
This procedure is used for larger stones. A small incision is made in the back, and a tube is inserted to remove the stone directly from the kidney.
What to expect: PCNL requires general anesthesia and a longer recovery time.

4. Open Surgery
In rare cases, a larger incision may be necessary to remove very large or complex stones.
What to expect: Open surgery requires more recovery time and is typically done only when other treatments fail.

What Happens During the Procedure?

Before surgery, your urologist will perform imaging tests like X-rays or CT scans to locate the stone. The procedure itself is usually done under anesthesia, so you’ll be comfortable and pain-free. After the surgery, you may experience some discomfort or blood in the urine as you pass stone fragments. Your doctor will provide follow-up care instructions to ensure a smooth recovery.

Conclusion

Stone surgery is an effective way to treat kidney stones, especially when other methods fail. If you’re dealing with kidney stones, understanding what happens during surgery can help you feel more prepared. Always consult your urologist for advice on the best treatment for your situation.