Partial Nephrectomy
What is Partial Nephrectomy?
A partial nephrectomy, also known as nephron-sparing surgery, is a procedure to remove a tumor or diseased portion of the kidney while preserving the remaining healthy kidney tissue. It’s often used for small renal tumors or in cases where preserving kidney function is critical (e.g., solitary kidney). In India, partial nephrectomies are performed in urology departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need Partial Nephrectomy?
Partial nephrectomy is indicated for:
- Kidney cancer:
- Renal cell carcinoma (RCC, 90% of kidney cancers; 3–5 per 100,000 in India).
- Small tumors (<4–7 cm, T1 stage; 60–70% of RCC cases are now detected early due to imaging).
- 5-year survival: 90–95% for localized RCC (T1); better functional outcomes than radical nephrectomy.
- Benign conditions:
- Benign tumors (e.g., oncocytoma, angiomyolipoma, if symptomatic).
- Localized kidney damage (e.g., trauma, infection, if isolated).
- Special cases:
- Solitary kidney, bilateral tumors, or chronic kidney disease (CKD) to preserve renal function.
- Associated treatments:
- Lymph node sampling (if high-risk cancer).
- Adjuvant therapy (e.g., immunotherapy like pembrolizumab) for high-risk RCC post-op.
- Timing:
- Performed in adults (average age 50–70 years for RCC); urgency depends on tumor growth (e.g., active surveillance for very small tumors).
The procedure aims to remove the tumor with clear margins, preserve kidney function, and reduce the risk of long-term dialysis, often using minimally invasive techniques to minimize recovery time.
Why Do Partial Nephrectomy Costs Vary in India?
Costs range from ₹1.5 lakh to ₹3.5 lakh :
- Procedure Type: Open (₹1.5–2 lakh); laparoscopic/robotic (₹2–3.5 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹2–3.5 lakh); lower in government hospitals (AIIMS: ₹50,000–₹1.5 lakh, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced urologists charge more.
- Additional Costs: Anesthesia (₹10,000–₹20,000), hospital stay (₹5,000–₹15,000/day), imaging (₹5,000–₹15,000), medications (₹5,000–₹10,000).
- Insurance: Often covered (medical necessity); confirm with your provider.
Partial Nephrectomy Procedure
- Before Surgery Evaluation:
- Assessment:
- Imaging: CT/MRI to assess tumor size, location, and depth (e.g., near renal artery or collecting system).
- Blood tests: Kidney function (creatinine, eGFR); blood sugar, clotting profile.
- Split renal function test (e.g., DMSA scan): Ensures remaining kidney function post-op.
- Preparation: Optimize kidney function; stop blood thinners (e.g., aspirin) 5–7 days prior if safe.
- Consent: Risks, including bleeding, are explained.
- Assessment:
- Surgical Techniques:
- Partial Nephrectomy:
- Performed under general anesthesia, lasting 2–4 hours.
- Approaches:
- Open partial nephrectomy: Incision (10–15 cm) in flank or abdomen; for complex tumors.
- Laparoscopic partial nephrectomy: 3–4 small incisions (5–10 mm); camera and instruments used.
- Robotic-assisted (e.g., da Vinci): Most common for partial; enhances precision, especially for complex tumors.
- Process:
- Kidney exposed; renal artery clamped (warm ischemia time <20–30 minutes to minimize damage).
- Tumor excised with margin (0.5–1 cm of healthy tissue); sent for pathology to confirm clear margins.
- Kidney defect repaired: Sutures to close collecting system (if entered) and renal parenchyma.
- Hemostasis: Hemostatic agents (e.g., Floseal) or sutures to control bleeding.
- Closure: Sutures for laparoscopic/robotic; sutures/staples for open; drain placed.
- Intraoperative Tools:
- Intraoperative ultrasound: Defines tumor margins.
- Robotic system: Enhances precision for suturing.
- Mannitol: IV diuretic to protect kidney during ischemia.
- Partial Nephrectomy:
- After Surgery:
- Hospital stay: 2–4 days (laparoscopic/robotic); 4–6 days (open).
- Care: Monitor kidney function (creatinine); drain removed in 2–3 days; hydrate well.
- Pain management: Moderate pain for 3–5 days; managed with painkillers (e.g., paracetamol).
- Instructions: Avoid heavy lifting for 6–8 weeks; monitor blood pressure (remaining kidney compensates).
Recovery After Partial Nephrectomy
- Hospital Stay: 2–4 days (laparoscopic/robotic); 4–6 days (open).
- Post-Surgery Care:
- Pain/Swelling: Moderate pain for 3–5 days; resolves in 1–2 weeks.
- Activity: Avoid strenuous activity for 6–8 weeks; light activities in 1–2 weeks.
- Incision: Laparoscopic scars (small, 5–10 mm) fade in 3–6 months; open scar (10–15 cm) fades in 6–12 months.
- Kidney function: Stabilizes in 1–2 months; typically 70–90% of pre-op function preserved (better than radical nephrectomy).
- Diet: Hydrate well; low-sodium diet to reduce kidney strain; avoid NSAIDs long-term.
- Follow-Up:
- Visits at 1 week (check healing), 1 month, and every 3 months for 2 years (cancer recurrence risk).
- Imaging: CT at 3–6 months for RCC surveillance; kidney function tests (creatinine, eGFR) annually.
Most resume normal activities in 3–4 weeks (laparoscopic) or 4–6 weeks (open); full recovery takes 6–8 weeks. Success rate: 5-year survival for localized RCC is 90–95%; local recurrence rate is 2–5% with clear margins.
Risks and Complications
- Surgical Risks:
- Bleeding (5–10%): During or post-op; may need transfusion or reoperation (1–2%).
- Infection (2–5%): At incision site; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Urine leak (2–5%): From kidney repair site; may need stent or drainage.
- Kidney function decline (5–10%): Temporary rise in creatinine; usually stabilizes; dialysis rare (<1%).
- Margin positivity (1–3%): Cancer at margins; may need radical nephrectomy.
- Injury to nearby organs (1–2%): Spleen, bowel; rare with experienced surgeons.
- Long-Term:
- Recurrence (2–5%): Cancer return; needs regular imaging.
- Hypertension (3–5%): From kidney stress; managed with medication.
Report fever, severe pain, decreased urine output, or swelling promptly.
Frequently Asked Questions (FAQs)
What causes the need for partial nephrectomy?
Kidney cancer (RCC), benign tumors, or localized kidney damage; often chosen to preserve kidney function.
Can I avoid partial nephrectomy?
Yes, if very small tumor: Active surveillance or ablation (e.g., RFA); surgery needed for larger tumors or growth.
Is partial nephrectomy painful?
Moderate pain for 3–5 days, managed with medication; resolves in 1–2 weeks.
How soon can I resume normal activities?
Light activities: 1–2 weeks; full recovery: 6–8 weeks; avoid strenuous activity for 6–8 weeks.
Is partial nephrectomy covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, decreased urine output, or swelling.
Will my kidney function be normal after surgery?
Mostly: 70–90% of pre-op function preserved; better than radical nephrectomy; monitor long-term.
Lifestyle changes post-surgery?
Stay hydrated, follow low-sodium diet, avoid kidney strain (e.g., NSAIDs), and attend follow-ups.
Conclusion
Partial nephrectomy is a safe and effective procedure for treating kidney cancer while preserving kidney function, with excellent outcomes for localized tumors. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult a urologist for personalized guidance.
Looking for Best Hospitals for Partial Nephrectomy
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
2,00,000 |
5,50,000 |
Ahmedabad |
2,50,000 |
6,00,000 |
Ajmer |
2,00,000 |
5,50,000 |
Aligarh |
2,00,000 |
5,50,000 |
Allahabad |
2,00,000 |
5,50,000 |
Amritsar |
2,25,000 |
5,75,000 |
Aurangabad |
2,25,000 |
5,75,000 |
Bangalore |
2,50,000 |
6,00,000 |
Bareilly |
2,00,000 |
5,50,000 |
Belgaum |
2,25,000 |
5,75,000 |
Bhopal |
2,25,000 |
5,75,000 |
Bhubaneswar |
2,25,000 |
5,75,000 |
Bikaner |
2,00,000 |
5,50,000 |
Chandigarh |
2,50,000 |
6,00,000 |
Chennai |
2,50,000 |
6,00,000 |
Coimbatore |
2,50,000 |
6,00,000 |
Dehradun |
2,25,000 |
5,75,000 |
Delhi |
2,50,000 |
6,00,000 |
Dhanbad |
2,00,000 |
5,50,000 |
Durgapur |
2,00,000 |
5,50,000 |
Faridabad |
2,50,000 |
6,00,000 |
Ghaziabad |
2,50,000 |
6,00,000 |
Gorakhpur |
2,00,000 |
5,50,000 |
Guntur |
2,25,000 |
5,75,000 |
Gurgaon |
2,50,000 |
6,00,000 |
Guwahati |
2,25,000 |
5,75,000 |
Gwalior |
2,00,000 |
5,50,000 |
Hyderabad |
2,50,000 |
6,00,000 |
Indore |
2,25,000 |
5,75,000 |
Jabalpur |
2,00,000 |
5,50,000 |
Jaipur |
2,50,000 |
6,00,000 |
Jalandhar |
2,25,000 |
5,75,000 |
Jamshedpur |
2,25,000 |
5,75,000 |
Jodhpur |
2,00,000 |
5,50,000 |
Kanpur |
2,00,000 |
5,50,000 |
Kochi |
2,50,000 |
6,00,000 |
Kolkata |
2,50,000 |
6,00,000 |
Kollam |
2,25,000 |
5,75,000 |
Lucknow |
2,25,000 |
5,75,000 |
Ludhiana |
2,50,000 |
6,00,000 |
Madurai |
2,25,000 |
5,75,000 |
Mangalore |
2,25,000 |
5,75,000 |
Meerut |
2,00,000 |
5,50,000 |
Moradabad |
2,00,000 |
5,50,000 |
Mumbai |
2,50,000 |
6,00,000 |
Mysore |
2,50,000 |
6,00,000 |
Nagpur |
2,25,000 |
5,75,000 |
Nashik |
2,25,000 |
5,75,000 |
Navi Mumbai |
2,50,000 |
6,00,000 |
Noida |
2,50,000 |
6,00,000 |
Patna |
2,00,000 |
5,50,000 |
Pune |
2,50,000 |
6,00,000 |
Raipur |
2,25,000 |
5,75,000 |
Rajkot |
2,25,000 |
5,75,000 |
Ranchi |
2,00,000 |
5,50,000 |
Surat |
2,50,000 |
6,00,000 |
Thane |
2,50,000 |
6,00,000 |
Vadodara |
2,25,000 |
5,75,000 |
Varanasi |
2,00,000 |
5,50,000 |
Visakhapatnam |
2,25,000 |
5,75,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.