Recovery After
Robotic Partial or Radical Nephrectomy

Recovery is broadly similar after both operations, because both are done through keyhole incisions. Two differences matter.

After a partial nephrectomy, where the tumour is removed and the rest of the kidney is preserved, a drain is sometimes placed in higher-risk cases, and there is a small additional risk of urine leaking from the cut surface or of bleeding in the weeks after surgery.

After a radical nephrectomy, where the whole kidney is removed, there is no such cut surface, but kidney function from then on depends on the other kidney.

You will be helped out of bed on the day of surgery and encouraged to walk a little and often. Breathing exercises help prevent chest infections.

Eating and drinking usually restart quickly. The bladder catheter is typically removed on the day after surgery, and any drain once its output settles. Pain is usually controlled with simple painkillers, sometimes with an anti-inflammatory.

Most people go home after one to two nights.

Tiredness is the most common complaint, and daytime naps are normal. Walk every day and build up gradually.

• keep the wound sites clean and dry; showering is usually fine
• bruising, and numbness around the incisions, are expected and settle over several weeks
• constipation is common after an anaesthetic and strong painkillers, and a gentle laxative helps
• drink enough to keep the urine pale
• avoid driving for about two weeks, and until you could make an emergency stop comfortably

Avoid heavy lifting and strenuous exercise for about four to six weeks, so the deeper tissues heal. Desk work is usually possible within two to three weeks, and physical work later. Energy usually returns to normal over one to two months.

Bleeding from the repaired kidney is uncommon, but it can happen up to several weeks after surgery, sometimes from a small abnormal blood vessel that forms as the kidney heals.

Seek urgent medical attention for heavy, visible blood in the urine, clots, or sudden pain in the flank. This is usually treated without further surgery, by blocking the affected vessel through a small tube in the groin.

A blood test a few weeks after surgery shows how the kidneys are working. After a partial nephrectomy, most of the function of that kidney is preserved. After removal of a whole kidney, the other kidney usually takes over well, although overall function is lower than before.

• have your blood pressure checked regularly, and treated if it is high
• stay well hydrated, particularly in hot weather or when unwell
• use anti-inflammatory painkillers sparingly and check with a doctor before regular use
• some people benefit from follow-up with a kidney specialist to help preserve function
• tell any doctor prescribing for you, or arranging a scan with contrast, that you have had kidney surgery

At the first appointment after surgery the pathology result is discussed: the type of kidney cancer, its grade, and whether it was completely removed. That determines the follow-up plan, which usually combines scans and blood tests over several years.

More on the conditions themselves is on the localised kidney cancer and renal mass pages.

Contact the clinic, or go to the Emergency Department at Subang Jaya Medical Centre if it is outside working hours, if you have:

• heavy blood in the urine, or clots
• sudden or worsening pain in the flank or abdomen
• fever, shivering or feeling generally unwell
• a wound that is red, hot, swollen or leaking fluid
• inability to pass urine
• calf pain or swelling, chest pain or breathlessness