Prof. Dr. Emel Akoğlu
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Kidney & Bladder
Kidney sparing surgery
What kidney sparing surgery is, how a partial nephrectomy removes a tumour and keeps healthy kidney, which tumours and patients qualify, how it compares with radical nephrectomy and ablation, approximate costs in Turkey against the UK, US and Germany, recovery milestones, risks and how to check a hospital.
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Prof. Dr. Zerrin Biçik Bahçebaşı
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Kidney sparing surgery in Turkey: what it is and how it works
Kidney sparing surgery, also called nephron-sparing surgery or partial nephrectomy, removes a tumour from the kidney together with a thin margin of healthy tissue, and leaves the rest of the kidney in place. It is used mainly for small kidney cancers and for some benign masses, so that the body keeps as much working kidney as possible. The surgeon exposes the kidney, finds the tumour with the help of imaging or ultrasound, may briefly clamp the blood vessels that supply it, cuts out the tumour and then closes the kidney with stitches to control bleeding and urine leakage. Urology departments in Turkey perform it by open, laparoscopic or robot-assisted routes.
This guide explains who qualifies, how it works step by step, how it compares with removal of the whole kidney, what it costs in Turkey against the UK, US and Germany, and what recovery involves. It is general information, not a treatment decision: that belongs with a urological oncology team who has seen your scans. See also our urology treatments in Turkey.
Why keep part of the kidney? What does the evidence say?
Healthy kidney tissue filters blood for life, and losing a whole kidney raises the long-term risk of chronic kidney disease, which in turn is linked to heart disease. Guidelines from the European Association of Urology and the American Urological Association recommend partial nephrectomy as the preferred surgical treatment for small tumours (stage T1a, up to 4 cm) when it can be done safely, and as an option for some larger ones. For these tumours, cancer control after partial nephrectomy is similar to that after radical nephrectomy, with better preservation of kidney function. The evidence is less clear for larger or deeper tumours, where the decision depends on location, the number of tumours and your other kidney. A surgeon should explain why they prefer one operation over the other for you.
Who is a candidate for kidney sparing surgery?
Good candidates have a tumour that can be removed with a clean margin while leaving enough healthy kidney, a body fit enough for general anaesthesia, and a clear staging scan. It is especially favoured when you have only one kidney, already have reduced kidney function, or have conditions that might affect the other kidney, such as diabetes, high blood pressure or a hereditary tumour syndrome. Tumours located deep in the kidney, close to the main vessels or the collecting system, or very large tumours, make it technically harder, and a radical nephrectomy may be advised instead. Some patients are not suitable for any surgery and are offered surveillance or ablation. The decision is made after reviewing CT or MRI images, kidney function tests and, sometimes, a biopsy.
How is kidney sparing surgery done, step by step?
The operation is under general anaesthesia and takes about two to four hours. In laparoscopic or robot-assisted surgery, four to five small cuts allow a camera and instruments; in open surgery a single flank incision is used. The surgeon frees the kidney, identifies the tumour, and often clamps the renal artery for a short period to reduce bleeding, trying to keep that time as short as possible to protect the kidney. The tumour is cut out with a margin, the defect is closed in layers, and the specimen is sent for pathology to confirm the type of tumour and whether the margin is clear. A drain may stay for one to three days. Most hospitals keep patients four to six days.
Partial nephrectomy, radical nephrectomy or ablation?
| Option | Best suited to | Typical limits |
|---|---|---|
| Kidney sparing surgery (partial nephrectomy) | Small and some larger tumours where a clear margin is possible | Technically demanding; risk of bleeding or urine leak |
| Radical nephrectomy | Large or central tumours, or tumours that involve the main vein | Whole kidney removed; higher long-term kidney-function risk |
| Ablation (freezing or heat) or surveillance | Small tumours in older patients or those unfit for surgery | Less long-term data; may need repeat treatment |
For the full-removal alternative, see our guides to nephrectomy and robotic radical nephrectomy. If a diagnosis is still unclear, a renal biopsy may be suggested to confirm what the mass is.
Kidney sparing surgery cost in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for the operation with hospital stay, not hospital quotes. Price depends on open, laparoscopic or robotic technique, the complexity of the tumour, the length of stay and the pathology and imaging required.
| Country | Approximate cost range |
|---|---|
| Turkey | €7,000 – €18,000 |
| United Kingdom | €14,000 – €30,000 |
| United States | €25,000 – €65,000 |
| Germany | €12,000 – €28,000 |
Robotic surgery costs more than open surgery because of the equipment, but it may shorten the stay. A package usually includes the pre-operative tests, surgeon and anaesthetist, the operating theatre, a ward stay, pathology, medication and transfers; ask whether intensive care, any transfusion and extra imaging are covered. A kidney operation for cancer should never be chosen by price alone.
Kidney sparing surgery recovery: stay, milestones and follow-up
For a cancer operation most international patients stay in Turkey about eight to twelve days: four to six in hospital and the rest nearby for the drain, catheter and wound checks, and for the surgeon to review the pathology report. After laparoscopic or robotic surgery people walk on the first day, eat normally within a couple of days and return to desk work after about three to four weeks; open surgery usually needs four to six weeks. Avoid heavy lifting and strenuous exercise for six weeks. Your kidney function is measured with blood tests, and a follow-up CT or ultrasound is scheduled at intervals set by the cancer team. Flying is normally allowed once the surgeon has cleared you; keep walking and drink water on the flight.
Kidney sparing surgery results: what to expect
There is no cosmetic result to photograph. Success is measured by complete removal of the tumour with a clear margin, by how much kidney function is preserved and by the absence of cancer on later scans. Most people keep kidney function close to its earlier level, though the operated kidney may work slightly less than before. The pathology report can show that a mass was benign, which is the case in a proportion of small masses, or it may show that cancer was fully removed or that further treatment is needed. Follow-up scans for several years are standard, because cancer can return, and an honest team will explain the schedule and the chance of recurrence for your tumour.
Risks and complications of kidney sparing surgery
Every operation carries risks, and this is a major one. The main concerns are bleeding, which occasionally needs transfusion or another procedure, and urine leaking from the kidney into the space around it. Other risks include infection, a temporary or permanent drop in kidney function, injury to nearby organs, blood clots in the legs, anaesthetic problems and, in a small number of patients, conversion to removal of the whole kidney if the tumour cannot be safely cut out. The NHS and the American Urological Association stress that the surgeon's volume and experience matter and that results are better in teams who do these operations regularly. Report fever, heavy bleeding in the urine, severe pain or a swollen wound at once.
How to choose a surgeon and hospital, and red flags
Look for a urologist or urological oncologist who performs partial nephrectomy often, in a licensed hospital with an intensive-care unit, blood bank, pathology service and, if robotic surgery is offered, a trained console surgeon. Ask for your scans to be reviewed before any commitment. Red flags are a quote without seeing the scans, a promise of cure, pressure to book immediately, no named surgeon and no plan for follow-up scans at home. Read how our process works and send your reports through the free quote page for a written plan and price.
Questions to ask the clinic:
- Is my tumour suitable for partial nephrectomy, and what is the alternative?
- Will it be open, laparoscopic or robotic, and how many have you done?
- How will you protect kidney function, and what happens if the kidney cannot be saved?
- Does the price include pathology, intensive care and any blood transfusion?
- Who reviews my follow-up scans after I return home?
Conditions treated with Kidney Sparing Surgery
Hospitals with Urology in Turkey
Frequently asked questions
Kidney sparing surgery, or partial nephrectomy, removes a kidney tumour with a margin of healthy tissue and leaves the rest of the kidney working. It is mainly used for small kidney cancers and some benign masses.
For small tumours, guidelines report similar cancer control to radical nephrectomy and better preservation of kidney function. Bleeding and urine leakage are more likely, so it should be done by an experienced team.
Approximate ranges are €7,000 to €18,000 in Turkey, against about €14,000 to €30,000 in the UK. The price depends on open or robotic technique, stay and pathology; the hospital confirms it in a written quote.
People with a tumour that can be removed with a clear margin, especially small tumours, a single kidney or reduced kidney function. Large or central tumours may require removal of the whole kidney instead.
After laparoscopic or robotic surgery most people return to desk work in three to four weeks; open surgery takes four to six. Heavy lifting is avoided for about six weeks.
You are under general anaesthesia. Afterwards there is soreness around the incisions, usually controlled with painkillers, and it is milder after keyhole or robotic surgery than after open surgery.
Risks include bleeding, urine leak, infection, reduced kidney function, blood clots and anaesthetic problems. Occasionally the whole kidney has to be removed if the tumour cannot be safely cut out.
It can in a minority of patients, so follow-up scans are scheduled for several years. The chance depends on the tumour type and grade, and the pathology report guides the schedule.
Neither is right for everyone. Surgery has more long-term data and a pathology report; ablation suits some small tumours in people unfit for surgery. Your urology team should explain the choice.
Plan about eight to twelve days: four to six in hospital, then nearby for drain, catheter and wound checks and for the pathology result, before the surgeon clears you to fly.
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