Kidney surgery to remove the primary kidney tumor is one of the main treatments for kidney cancers both if patients have cancer confined to the kidney or if the cancer has spread to other sites. Removal of the primary kidney tumor can be done in a number of ways. An open radical nephrectomy is the traditional approach to kidney surgery. During this operation, the entire kidney bearing the tumor is removed through a large incision in the flank. A partial or kidney-sparing nephrectomy is an operation that can be effective for treating small kidney tumors (less than 4 cm) not located at the center of the kidney. During a partial nephrectomy, the surgeon removes the tumor and a small margin of normal tissue around it, thus only removing the part of the kidney affected by tumor and allowing healthy tissue to remain.
More recently, laparoscopic surgeries to remove kidney tumors have been possible. In these minimally invasive operations three or four small incisions are made, through which surgical instruments and a camera can be placed. Using techniques developed at Columbia University, surgeons can perform a radical or partial nephrectomy laparoscopically. Patients who undergo minimally invasive surgery often have significantly less pain, less blood loss, cosmetically acceptable smaller incisions, a shorter hospital stay, and more rapid recovery when compared with open surgery.
Operations to remove kidney cancer, especially those done with a minimally invasive approach, can be technically challenging, and the expertise, experience, and planning of the surgeon can affect the outcome of the surgery. Doctors at The Herbert Irving Comprehensive Cancer Center have been at the forefront in advancing surgical techniques for kidney cancers for decades. For example, technically complicated surgeries where tumors are close vital structures such as the vena cava, the main vein leading into the heart, is done in collaboration with New York-Presbyterian heart surgeons to remove the cancer.