Kidney Cancer Surgery
Robotic Kidney Surgery: Partial and Radical Nephrectomy
Kidney tumors are usually found on imaging, often by chance during a scan done for another reason. When surgery is recommended, there are two main operations. A partial nephrectomy removes the tumor and a thin margin of surrounding tissue while leaving the rest of the kidney in place. A radical nephrectomy removes the whole kidney, sometimes with the adrenal gland and nearby lymph nodes. Both can be performed robotically through small incisions.
Overview
Which operation is appropriate depends on the size and position of the tumor, how the kidneys are functioning, and the patient's overall health. Preserving kidney tissue is generally preferred when the tumor allows it. Not every kidney mass needs immediate surgery. Small masses may be monitored with periodic imaging, and a needle biopsy is sometimes used to learn more before deciding.
Who May Be a Candidate
Whether this treatment is appropriate is an individual decision made with your care team. In general it may be considered for:
- A kidney mass that is suspicious for cancer on CT or MRI, or confirmed by biopsy.
- For partial nephrectomy, a tumor whose size and location allow it to be removed while leaving a functioning kidney behind.
- For radical nephrectomy, a larger or centrally located tumor, or one where removing the whole kidney is the safer option.
- Patients whose kidney function, other medical conditions and preferences have been reviewed with their care team, including the option of surveillance for small masses.
What Is Typically Involved
- 1Imaging review, kidney function blood tests and a pre-operative visit.
- 2Surgery under general anesthesia. During a partial nephrectomy the blood supply to the kidney is usually clamped for a short period, called warm ischemia time, while the tumor is removed and the kidney is repaired.
- 3A hospital stay of one to two nights for most patients, with early walking encouraged.
- 4A pathology report within one to two weeks describing the tumor type, grade and margins.
- 5Follow-up imaging and kidney function tests at intervals set by the care team, which depend on the pathology results.
A more detailed, plain-language guide to preparing for and recovering from this surgery, in English and Spanish, is in the Kidney Surgery (Nephrectomy) patient guide.
Questions Patients Often Ask
Do I need the whole kidney removed?
Not necessarily. Many kidney tumors can be removed with a partial nephrectomy that preserves the rest of the kidney. Whether that is possible depends mainly on the tumor's size and position. Your surgeon will review your imaging with you and explain which operation is recommended and why.
Can I live normally with one kidney?
Most people with one healthy kidney live normal lives. The remaining kidney generally provides enough function. Protecting it matters, so your care team may advise on blood pressure control, hydration, and avoiding medicines that stress the kidneys.
What is warm ischemia time?
During a partial nephrectomy the blood flow to the kidney is often paused briefly so the tumor can be removed with little bleeding. That pause is the warm ischemia time. Surgeons aim to keep it short to protect kidney function. Dr. Khandekar's research includes automated measurement of this interval from surgical video.
Will I need chemotherapy or other treatment after surgery?
Most localized kidney cancers are treated with surgery alone, followed by monitoring. For some higher-risk tumors, additional treatment after surgery may be discussed with a medical oncologist. The recommendation depends on the pathology report.
Can a small kidney mass be watched instead of removed?
Sometimes. Small kidney masses, particularly in older patients or those with other health conditions, may be followed with periodic imaging rather than treated right away. This is called active surveillance. It is a decision made together with your care team based on the mass and your overall health.
Related Procedures
Discuss Your Options
This page is general information and is not a recommendation for any individual. To discuss whether this treatment is appropriate for you, request a consultation through UHealth or call (305) 243-6090. Please do not send personal health information through this website.
Request an AppointmentEducational content reviewed by Archan Khandekar, MD. Last updated 2026-09-19. This material is general in nature, does not constitute medical advice, and does not create a physician-patient relationship. Individual care decisions should be made with your own treating physicians.
Schedule a Consultation
Dr. Khandekar sees patients across the University of Miami Health System and Sylvester Comprehensive Cancer Center. Request an appointment for urologic oncology care.