Laparoscopic Radical Nephrectomy

There are times when medicines, monitoring or smaller procedures are not enough to manage a kidney problem. In those situations, the kidney may need to be removed through a keyhole approach. This type of surgery is referred to as a laparoscopic radical nephrectomy. It is discussed whether the scans indicate a growth that requires surgical attention or whether the kidney has declined to the point where it is no longer helping the body effectively.

Instead of a large open incision, the procedure uses a camera (laparoscope) and slim instruments. This approach is generally associated with a shorter hospital stay and a steadier return to routine activity for many patients. The suitability of the procedure depends on scans, blood tests, kidney function, and the patient’s overall medical fitness.

Laparoscopic radical nephrectomy is available at Gleneagles Hospitals as part of our advanced urology services.

A laparoscopic radical nephrectomy involves the removal of:

• The affected kidney

• Surrounding fatty tissue

• Sometimes, nearby lymph nodes are removed if medically indicated

A camera is inserted through a small incision, allowing the surgeon to operate while viewing the surgical area on a monitor. Instruments are placed through two to four additional keyhole openings to complete the procedure.

This operation is considered when:

• There is a kidney tumour that requires complete removal

• The kidney has become non-functional and is contributing to illness or discomfort
• There is a strong suspicion of cancer on imaging or biopsy

• Persistent disease is present, and preserving the kidney is not possible

The remaining kidney typically continues filtration if it is healthy and functioning well.

Doctors consider this surgery after reviewing imaging (CT/MRI/ultrasound), kidney function tests, and the patient’s symptoms. It is not suggested for every abnormal finding; it is recommended when evidence shows that the kidney cannot be salvaged or when delay may create further risk.

Common medical reasons include:

• Masses or tumours that need complete removal

• Renal growths where partial nephrectomy is not an option
• Kidneys that no longer contribute to function and cause infections or pain
• Recurrent infections linked to a damaged kidney

• Concerns about the spread of disease beyond the kidney

Each case is reviewed on its own merits at Gleneagles Hospitals. The treatment plan is guided by test results and imaging findings, along with expert consultation, to ensure the choice is appropriate for the patient’s condition.

In some situations, laparoscopic access may not be the first choice. Alternatives may be discussed if:

• A person has severe heart or lung conditions affecting anaesthesia tolerance

• Imaging shows a very large tumour requiring open access
• There is dense internal scarring from previous operations

• Medical conditions make carbon dioxide inflation (used in laparoscopy) unsafe

When this comes up, the urology specialists at Gleneagles Hospitals guide the decision based on test results, kidney function, and overall health, recommending the option that carries the least risk.

Before the operation, the Gleneagles Hospitals team explains how the procedure is done, what steps come first, and how recovery will be managed. Patients are encouraged to ask anything that comes to mind, so nothing feels unclear.

Preparation Before the Procedure:

• Before the surgery date, the team meets with the patient to confirm that they are ready for the procedure. This includes assessing kidney function, performing basic blood tests, conducting an ECG, and ensuring that anaesthesia is safe for them.

• Patients receive clear instructions before the procedure, including how long to fast and which medicines need to be adjusted. Blood thinners, pain relievers, or other routine tablets are discussed with the doctor so changes can be made safely in advance.
• Informing the staff about any known allergies, including reactions to medicines, latex, or products used to clean the skin before surgery.
• Making simple arrangements for support at home in the first couple of days after discharge.

• These steps are part of routine surgical planning so the procedure and recovery start smoothly.

During the Procedure:

• The surgery is done under general anaesthesia.

• Small cuts are created on the abdomen to begin the procedure. A camera and slender surgical tools are passed through these openings to reach the kidney. Gas is introduced to create space inside the abdomen, making it easier for the surgeon to see and work.
• The kidney and related tissues are separated and removed through one incision, which may be slightly widened for extraction.
• Nearby structures are avoided during the procedure. On average, the surgery lasts about three to four hours. Still, the exact timing may vary depending on individual anatomy and the findings observed during the operation.

After the Procedure

After surgery, the patient is moved to a recovery area until fully awake. Movement is usually started early, based on comfort.

Common early experiences after laparoscopic radical nephrectomy:

• Discomfort at incision sites

• Tiredness or heaviness in the abdomen
• Temporary shoulder discomfort from the gas used for visibility
• A urinary catheter is used for a short time, removed when appropriate

• Many patients go home after one to two days, depending on how they feel and the doctor’s advice.

During these first days, the staff at Gleneagles Hospitals stay involved. Nurses, anaesthesia staff, and the urology team check progress, help with mobility, and guide patients on what is normal and what should be reported.

Laparoscopic radical nephrectomy is a recognised approach in urology, but, like any surgery, it carries certain risks. These may include:

• Bleeding

• Infection of incisions or the urinary tract
• Reactions to anaesthesia
• Injury to surrounding tissues (not common)

• Change in kidney function due to the removal of the affected kidney

These points are discussed with the patient prior to surgery as part of informed consent.

At Gleneagles Hospitals, this surgery is provided by the urology department as a routine service for patients requiring kidney removal.

• Laparoscopic setup

  Equipment used for keyhole kidney procedures, with visual guidance systems for surgical access.

• Operating theatre environment

  Operating theatres are arranged for minimally invasive urological surgery, with precise imaging and comprehensive monitoring.

• Urology team

  The hospital’s urology unit handles the procedure as part of regular operative work.

• Anaesthesia and nursing

  Anaesthesia and nursing staff are present throughout the procedure for intraoperative support.

• Recovery and follow-up

  Patients are observed after surgery and advised regarding activity, medicines, and follow-up visits based on progress.

Laparoscopic radical nephrectomy becomes an option when a kidney cannot be preserved due to disease or poor function. The decision is guided by imaging reports, kidney function, and the patient’s medical condition. At Gleneagles Hospitals, the approach is thoroughly discussed with the patient so they understand why surgery is being considered and what recovery may involve. Those seeking clarity or a second opinion can contact the hospital to speak with the urology team.