When a patient is diagnosed with a kidney tumour, one of the most important decisions we make is whether to remove the entire kidney (total nephrectomy) or only the tumour-bearing portion (partial nephrectomy). Both approaches are highly effective, especially with the precision of robotic surgery.
What Is a Partial Nephrectomy?
A partial nephrectomy removes only the tumour while preserving as much normal kidney tissue as possible. This is the preferred option whenever it is safe and technically feasible.
- Ideal for small renal masses (typically <4 cm, sometimes up to 7 cm)
- Useful when the tumour is located at the pole or outer surface of the kidney
- Recommended for patients with diabetes, hypertension, or risk of future kidney disease
- Essential for patients with a single kidney
The goal is simple: cancer control while maximising kidney preservation.
What Is a Total Nephrectomy?
A total nephrectomy involves removal of the entire kidney along with surrounding fat and tissue. This is chosen when a partial nephrectomy may compromise safety or cancer clearance.
- Large or centrally located tumours
- Tumours involving major vessels or the collecting system
- Poor baseline kidney function on the affected side
- When nephron-sparing is not safe or feasible
How We Decide – Key Factors
Each patient is evaluated individually. The decision between partial and total nephrectomy is based on:
- RENAL/Padua score – anatomical complexity of the tumour
- Tumour size, location, and depth
- Function of both kidneys (DTPA/MAG3 scan if needed)
- Safety of obtaining clear margins
- Overall health and long-term kidney preservation goals
With robotic surgery, we can perform precise dissection, control bleeding effectively, and preserve nephrons even in complex cases — reducing the need for total nephrectomy.
The Bottom Line
Both partial and total nephrectomy are effective cancer treatments. Our priority is to remove the tumour completely while protecting kidney function for the long term. A personalised approach ensures the safest and best outcome for each patient.