Last updated: 18-Oct-2026
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Dr Swati Shah
MS, DrNB (Surgical Oncology)
Kidney Cancer Surgeon
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad · 18 years of experience
★★★★★ 4.99 from 85 Google reviews (Gota clinic) · 5.0 from 28 (Apollo, Bhat)
IN SHORT
In a partial nephrectomy, the kidney’s artery is closed briefly. The tumour is cut out with a thin rim of healthy tissue, and the kidney is sewn shut.
In a radical nephrectomy, the whole kidney comes out with its fat. The adrenal gland and lymph nodes are taken only when the scan or operation shows a reason.
Robotic, keyhole or open is decided by tumour size and position, any tumour clot in the vein, and earlier surgery. Robotic surgery is preferred for removing small tumours.
This page is one part of a larger guide. For how kidney cancer is treated, when the kidney can be saved and how the operation is planned, start with our kidney cancer surgery guide.
The kidney sits deep at the back of the belly. The same operation can be done through small cuts or one larger cut. Whether the tumour or the whole kidney comes out is a separate choice, made first. That choice is explained on the keep-or-remove-the-kidney page. This page is about how the chosen operation is done.
| Route | How it is done | Where it is used |
|---|---|---|
| Robotic | Small cuts. The surgeon sits at a console beside you and controls every movement of the instruments. | The preferred route for removing a small tumour and keeping the kidney. This is available at Apollo, Bhat. |
| Keyhole (laparoscopic) | Small cuts, a camera and long straight instruments held by the surgeon. | Often used for removing the whole kidney when the tumour is confined to it. |
| Open | One larger cut on the side or the front of the belly. | Very large tumours, a tumour clot high in the main vein, or many earlier operations. |
Any robotic or keyhole operation may need to change to open during surgery. This is explained and agreed before the operation.
The CT report gives the tumour a complexity score. When removing the tumour alone is borderline, the cancer team decides together, not on the day of surgery.
A partial nephrectomy removes the tumour and keeps the rest of the kidney working. It is the standard operation for small tumours wherever it can be done safely.
While the artery is closed, the kidney gets no blood. The aim is to keep this warm clamp time under about 25 minutes. The team uses several ways to protect the kidney.
| Method | What it means |
|---|---|
| Early unclamping. | The clamp comes off as soon as the main stitches are in. |
| Selective clamping. | Only the branch artery feeding the tumour’s part of the kidney is closed. |
| No clamp. | For some small tumours on the surface, the tumour is removed without closing the artery. |
| Cooling with ice. | When a longer clamp time is expected, the kidney is cooled to protect it. |
A thin rim of healthy kidney, about one millimetre and free of cancer, is enough. Taking extra kidney for comfort only loses working kidney without making the operation safer.
The removed tumour goes to the pathologist, who checks that the cut edge is clear. If the tumour cannot be removed safely, or a clear edge cannot be reached, the whole kidney is removed instead. This change is always explained and agreed before every partial nephrectomy.
A radical nephrectomy removes the whole kidney with its covering of fat. It is used for large tumours, and for tumours where keeping part of the kidney is not safe.
Sometimes the tumour grows as a clot into the kidney vein, or into the main body vein. Its upper level is measured on MRI or CT before surgery. A clot in the kidney vein or the lower main vein is removed by the urology cancer team. A clot behind the liver or near the heart needs heart and blood-vessel surgeons. Bypass is kept ready. This is never an unplanned operation. How the stage changes the plan is on the kidney cancer stages page.
No. Robotic surgery is preferred for removing a small tumour and keeping the kidney. Large tumours, or a clot high in the vein, may need keyhole or open surgery.
The kidney's artery is closed for a short time, so the tumour can be cut out without heavy bleeding. The aim is to keep this under about 25 minutes.
Yes. A robotic or keyhole operation may change to open. A partial nephrectomy may become removal of the whole kidney if the tumour cannot be removed safely. Both are agreed before surgery.
No. It is removed only when the scan or the operation shows it is involved, or an upper-pole tumour presses on it.
No. Nodes are removed when the scan shows them enlarged, mainly to stage the cancer. They are not cleared widely when they look normal.
Whether to keep or remove the kidney is explained on the nephron-sparing decision page. The tests before surgery are on the kidney mass work-up page. For questions, call +91-63590-11009. Gota OPD, Gota, Ahmedabad.
Shah’s Gastro, Cancer & Robotic Surgery Centre
Dr Swati Shah — MS, DrNB (Surgical Oncology) · Kidney Cancer Surgeon
Consultation: Gota OPD, Gota, Ahmedabad. Surgery: Apollo Hospital, Bhat, Gandhinagar.
Gota OPD — Gota, Ahmedabad, Gujarat
Apollo Hospital, Bhat, Gandhinagar — Apollo Hospital International Limited, Plot No. 1 A, GIDC Bhat Industrial Estate, Bhat, Gandhinagar, Gujarat
Call: +91-63590-11009 · WhatsApp: +91-63590-11009
Told you need a kidney operation and want to know how it will be done? Bring your CT report and kidney function tests to the visit. The route is decided at the consultation, after examination. Call +91-63590-11009 Send your reports before the visit
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