Open Partial Nephrectomy: Surgery, Recovery Timeline and Risks
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is an open partial nephrectomy?
An open partial nephrectomy is surgery that removes only the diseased or damaged part of a kidney through a flank incision, then rebuilds the kidney so it can keep filtering blood. It often treats kidney cancer. The operation takes three to four hours, the hospital stay is two to four days, and most people fully recover within 12 weeks. [1]
What the research says
Saving part of the kidney protects long-term kidney function. In a pooled analysis of 21 studies with 11,204 patients who had larger kidney tumors, partial removal left kidney filtering (eGFR) about 12.4 mL/min higher and lowered the risk of new chronic kidney disease by about 64% (RR 0.36) compared with removing the whole kidney, although complications were more likely (RR 1.74). (Mir et al., European Urology, 2017) [2]
Survival held up even for tumors 7 cm or larger. Across 13 studies with 2,906 patients, partial removal was linked to better overall survival (HR 0.76) and similar cancer-specific survival versus whole-kidney removal, at the cost of about 65 minutes more operating time and more surgical complications. (Deng et al., Urologic Oncology, 2019) [3]
Robot-assisted partial surgery is a lower-complication option when it suits the tumor. In 8 studies with 3,418 patients, the robotic approach had fewer complications than open surgery (19.3% vs 29.5%), a hospital stay about 2.8 days shorter and less blood loss, with similar kidney function and surgical margin results. (Wu et al., PLoS One, 2014) [4]
Key takeaways
The goal is to fix the kidney problem while keeping as much healthy kidney tissue as possible. [1]
Surgery lasts three to four hours under general anesthesia, through a cut of about 30 cm (12 inches) in the side. [1]
Expect two to four days in the hospital and about four weeks before heavy lifting, strenuous exercise or a return to most jobs. [1]
A fever of 38°C (100.4°F) or higher, blood in the urine or heavy bleeding from the incision needs a prompt call to your care team. [1]
Who needs an open partial nephrectomy?
An open partial nephrectomy is used for people whose kidney has a disease or injury that affects only part of the organ. Surgeons most often perform it for kidney cancer. [1]
Only the diseased part of the kidney is removed; the rest is rebuilt.
Other reasons include: [1]
Infection in part of the kidney
Damage from kidney stones
Injury to the kidney
Birth defects affecting the kidney
High blood pressure caused by problems with the kidney's blood supply (see renal artery stenosis)
Kidney cancer can be fatal without treatment. For most people, the risks of leaving it untreated are greater than the risks of the surgery. [1]
How is an open partial nephrectomy different from robotic or radical kidney surgery?
An open partial nephrectomy removes part of the kidney through one or more large cuts, while a radical nephrectomy removes the entire kidney. A partial approach is usually chosen when the tumor is small enough that the whole kidney does not need to come out. [1]
Partial nephrectomy itself can be done in two ways. A robotic partial nephrectomy may be recommended for a small tumor, while some people with a large tumor need the open procedure. [1]
Feature | Open partial nephrectomy | Robotic partial nephrectomy | |
What is removed | Diseased part of the kidney | Diseased part of the kidney | The whole kidney |
Access | Large flank incision, about 30 cm (12 in) | Robot-assisted surgery | Open, laparoscopic or robotic |
Kidney after surgery | Rebuilt and still filtering blood | Rebuilt and still filtering blood | Removed |
Often suited to | Larger tumors that still allow kidney-sparing surgery | Smaller tumors | Cases where the kidney cannot be saved |
Small kidney tumors can sometimes be treated without surgery at all. Learn more in our guide to ablation for kidney cancer.
How do you prepare for an open partial nephrectomy?
Preparing for an open partial nephrectomy starts with a visit where a healthcare provider confirms which procedure suits you and checks your temperature, pulse and blood pressure. [1]
Tell your provider about: [1]
All medicines and supplements. Aspirin, anti-inflammatory drugs, blood thinners and some herbal supplements raise bleeding risk. You may need to stop them before surgery, but only after your provider tells you to.
Allergies. Include medicines, skin cleaners such as iodine or isopropyl alcohol, latex and foods.
Fasting: You usually cannot eat or drink anything after midnight the night before surgery. If you must take medicine that morning, take it with a small sip of water. [1]
What happens during an open partial nephrectomy?
An open partial nephrectomy usually takes three to four hours and follows nine main steps. [1]
The surgery usually takes three to four hours.
General anesthesia puts you into a painless sleep.
A urinary catheter — a flexible tube — drains urine from the bladder into a bag.
A flank incision of about 30 cm (12 inches) is made on the side of the torso, between the hip and the ribs.
Clamps block the blood vessels that carry blood into and out of the kidney.
The problem area, such as the tumor, is removed.
The kidney is sewn back together.
The clamps are removed so blood flows to the kidney again.
A temporary surgical drain may be left to clear fluid from around the kidney.
The incision is closed with stitches or staples.
Sources: [1]
Open partial nephrectomy at a glance
Item | Typical detail |
Anesthesia | General (you are asleep) |
Operating time | 3–4 hours |
Incision | About 30 cm (12 in) in the flank |
Tubes after surgery | Urinary catheter; sometimes a temporary drain |
Hospital stay | 2–4 days |
Full recovery | Most people within 12 weeks |
Sources: [1]
What happens right after an open partial nephrectomy?
Right after an open partial nephrectomy, the removed tissue goes to a lab and you are moved to a recovery room to wake up. [1]
Over the next few days, the care team will: [1]
Treat pain and nausea
Keep you on a liquid diet for one to two days so your body can recover
Encourage you to walk the day after surgery to improve blood flow and prevent complications
Remove the urinary catheter after one to two days
Send you home once it is safe
How long does recovery from an open partial nephrectomy take?
Recovery from an open partial nephrectomy usually means two to four days in the hospital, about four weeks of activity limits and full recovery for most people within 12 weeks. Your exact timeline depends on the type of surgery, your health history and any other conditions you have. [1]
Most people fully recover within about 12 weeks.
Activity | When it is usually allowed |
Walking and climbing stairs | Right away, with no restrictions |
Driving | 24 hours after you stop narcotic pain medicine |
Lifting more than 10 lb (about 4.5 kg) | After 4 weeks |
Running, cycling and other strenuous exercise | After 4 weeks |
Returning to work | About 4 weeks; sooner for desk jobs, later for physical jobs |
Full recovery | Most people within 12 weeks |
Sources: [1]
You will not be able to lift anything for at least several days after you get home, so plan for a family member or friend to help you during that time. [1]
What are the benefits and risks of an open partial nephrectomy?
The main benefit of an open partial nephrectomy is that it treats the kidney condition without removing the entire kidney. [1]
Like any major surgery, it carries risks: [1]
Risk | What it means |
Anesthesia reaction | An unwanted response to the drugs that put you to sleep |
Bleeding or hematoma | Blood loss, or a collection of clotted blood |
Blood transfusion | Donated blood may be needed |
Blood clots | Clots that can form in the veins after surgery |
Infection | At the incision or inside the body |
Seroma | Fluid buildup at the surgical site |
Healing problems | The wound may heal slowly or open |
Kidney dysfunction | The remaining kidney may not work as well |
If the kidney cannot be saved, or if you want to understand life after whole-kidney removal, see our guide to radical nephrectomy.
For background on how the organ works, read the kidney: anatomy and function.
What follow-up is needed after an open partial nephrectomy?
Follow-up after an open partial nephrectomy includes a visit one to two weeks after surgery to remove staples or drains and to review the pathology results. [1]
Pathology review: A pathologist examines the removed tumor under a microscope to identify its type. [1]
Cancer checks: If kidney cancer was removed, you will usually have CT scans or other imaging, sometimes at three, six or 12 months after surgery, depending on the cancer type. [1]
Long-term plan: Your provider will set a schedule for future imaging and blood work based on the pathology. [1]
If the tumor turns out to be a specific type, our guides to clear cell renal cell carcinoma and renal oncocytoma explain what comes next.
When should you call a doctor after an open partial nephrectomy?
After an open partial nephrectomy, contact your healthcare provider right away if you notice any of these signs: [1]
Heavy bleeding from the incision
Discolored drainage from the incision
A fever of 38°C (100.4°F) or higher
Signs of infection
A bad smell around the surgical site
Skin separating at the stitches
Pain that is getting worse
Conclusion
An open partial nephrectomy is a common and effective way to treat kidney cancer and other kidney problems while keeping the healthy part of the kidney working. The surgery takes a few hours, the hospital stay is short, and most people are back to normal life within about three months. [1]
The best results come from good preparation, steady activity during recovery, keeping every follow-up visit and acting quickly on warning signs. If you have questions about your own surgery, write them down and bring them to your surgeon or urologist.
Keep learning: Explore our chronic kidney disease guide to learn how to protect your kidney function for the long term, or read our full kidney cancer guide. For a broader overview of kidney cancer treatment options, see this kidney cancer treatment summary and this nephrectomy patient overview.
FAQ
What is an open partial nephrectomy?
An open partial nephrectomy is surgery that removes only the diseased or damaged part of a kidney through a large flank incision. The surgeon then rebuilds the kidney so it can keep filtering blood.
Why would a doctor remove only part of a kidney?
A doctor removes only part of a kidney to treat the problem while keeping as much healthy tissue as possible. Common reasons include kidney cancer, infection, kidney stone damage, injury, birth defects and high blood pressure from blood supply problems.
How long does an open partial nephrectomy take?
An open partial nephrectomy usually takes three to four hours. It is done under general anesthesia, so you are asleep for the whole operation.
How long will I stay in the hospital after an open partial nephrectomy?
The typical hospital stay after an open partial nephrectomy is two to four days. The urinary catheter usually comes out after one to two days, and walking starts the day after surgery.
How long is recovery after an open partial nephrectomy?
Recovery after an open partial nephrectomy takes about four weeks before heavy lifting, strenuous exercise or most jobs, and most people fully recover within 12 weeks. Walking and climbing stairs are allowed right away.
When can I drive after an open partial nephrectomy?
Driving after an open partial nephrectomy is usually allowed 24 hours after you stop taking narcotic pain medicine. Check with your surgeon if you are unsure.
What are the risks of an open partial nephrectomy?
The risks of an open partial nephrectomy include anesthesia reactions, bleeding or hematoma, the need for a blood transfusion, blood clots, infection, fluid buildup (seroma), healing problems and reduced kidney function.
How do I prepare for an open partial nephrectomy?
Tell your provider about all prescription, over-the-counter and herbal products, because aspirin, anti-inflammatory drugs, blood thinners and some supplements raise bleeding risk and may need to be stopped. [1] Report allergies to medicines, iodine or isopropyl alcohol, latex and foods. You typically can't eat or drink after midnight (take needed medicines with a small sip of water), and arrange for family or a friend to help with daily tasks afterward. [1]
Does an open partial nephrectomy hurt, and what anesthesia is used?
The surgery is done under general anesthesia, so you are in a painless sleep. [1] In the recovery room the team treats pain and nausea, and pain that gets worse after you go home is a reason to contact your provider. [1]
When should I seek urgent care after an open partial nephrectomy?
Urgent care after an open partial nephrectomy is needed for a fever of 38°C (100.4°F) or higher, blood in the urine, heavy bleeding or discolored drainage from the incision, a bad smell, skin separating at the stitches or worsening pain.
Related Reading
References
Cleveland Clinic. Partial Nephrectomy: Purpose, Types, Procedure & Recovery. Cleveland Clinic. Last updated April 20, 2026. https://my.clevelandclinic.org/health/treatments/16214-open-partial-nephrectomy
Mir MC, Derweesh I, Porpiglia F, et al. Partial Nephrectomy Versus Radical Nephrectomy for Clinical T1b and T2 Renal Tumors: A Systematic Review and Meta-analysis of Comparative Studies. Eur Urol. 2017;71(4):606-617. PMID 27614693. https://doi.org/10.1016/j.eururo.2016.08.060
Deng W, Chen L, Wang Y, et al. Partial nephrectomy versus radical nephrectomy for large (≥ 7 cm) renal tumors: A systematic review and meta-analysis. Urol Oncol. 2019;37(4):263-272. PMID 30704957. https://doi.org/10.1016/j.urolonc.2018.12.015
Wu Z, Li M, Liu B, et al. Robotic versus open partial nephrectomy: a systematic review and meta-analysis. PLoS One. 2014;9(4):e94878. PMID 24740259. https://doi.org/10.1371/journal.pone.0094878
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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