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Partial Kidney Removal Surgery In Singapore

Receiving a diagnosis of a kidney tumour or mass can understandably lead to uncertainty and concern. Partial kidney removal surgery, medically known as partial nephrectomy, is a kidney-sparing procedure that removes only the diseased portion of your kidney while preserving healthy tissue. This surgical approach has become the preferred treatment for many kidney tumours, helping patients maintain kidney function while treating their condition. At TTW Urology, Dr Tan specialises in performing partial nephrectomy using established surgical techniques to preserve your kidney function and quality of life.

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Dr Tan Teck Wei

MBBS|DFD (CAW)|MRCS|MMed (Surgery)|FAMS (Urology)

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Kidney disease, Chronic kidney disease ckd, Doctor hold human mo Partial Kidney Removal Surgery in Singapore
Overview Candidate Treatment Process Recovery Benefits Risks Costs FAQ
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Overview
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FAQ

What is Partial Nephrectomy?

Partial nephrectomy is a surgical procedure that removes only the tumour or diseased portion of the kidney along with a small margin of healthy tissue, rather than removing the entire organ. This kidney-sparing surgery is suitable for most small kidney tumours (typically less than 7cm) while preserving as much healthy kidney tissue as possible. The procedure completely removes the cancerous or abnormal tissue while maintaining kidney function for the patient’s long-term health.

During partial nephrectomy, the surgeon carefully excises the tumour and a thin rim of normal tissue surrounding it, ensuring complete removal while minimising damage to the remaining kidney. This approach differs from radical nephrectomy, where the entire kidney is removed. The preserved kidney tissue continues to filter waste from the blood, helping patients maintain kidney function and reducing the risk of chronic kidney disease.

Who is a Suitable Candidate?

Ideal Candidates

Ideal Candidates

  • Patients with small kidney tumours (typically less than 4 cm; tumours up to 7 cm may be considered based on location and other factors).
  • Individuals with tumours in accessible locations of the kidney that allow for safe removal.
  • Patients with a single functioning kidney who require tumour excision while preserving renal function.
  • Those with bilateral kidney tumours requiring kidney-sparing surgery.
  • Individuals with underlying kidney-impacting conditions (e.g. diabetes, hypertension).
  • Patients at increased risk for future kidney disease who benefit from kidney-sparing surgery.
  • Younger patients at risk of long-term kidney function decline.
  • Individuals with hereditary kidney cancer syndromes, such as Von Hippel–Lindau, requiring repeated surgeries.
Contraindications

Contraindications

  • Centrally located tumours involving major renal blood vessels.
  • Very large tumours where partial resection would leave inadequate functional tissue.
  • Patients with poor general health or comorbidities precluding safe anaesthesia or surgery.
  • Uncorrected severe bleeding disorders.
  • Active urinary tract infections, which must be resolved before surgery.
  • Tumours extensively involving the renal collecting system.
  • Cases where complete cancer removal cannot be achieved without full nephrectomy.

The decision between partial and radical nephrectomy requires careful evaluation by an experienced urologist. Tumour size, location, patient age, overall kidney function, and presence of other medical conditions determine the appropriate surgical approach for each patient.

Partial Nephrectomy Treatment Techniques

partial kidney-technique-open

Open Partial Nephrectomy

Open partial nephrectomy involves making an large incision in the flank or abdomen to directly access the kidney. This traditional approach provides visibility and tactile feedback for the surgeon, allowing precise tumour removal and reconstruction of the remaining kidney. Open surgery may be preferred for larger tumours, centrally located masses, or cases where kidney anatomy is complex. The surgeon can directly control bleeding and ensure complete tumour removal with clear margins.

partial kidney-laparoscopic

Laparoscopic Partial Nephrectomy

Laparoscopic partial nephrectomy uses several small incisions through which a camera and specialised instruments are inserted. This minimally invasive approach offers reduced post-operative pain, shorter hospital stays, and faster recovery compared to open surgery. The magnified view provided by the laparoscope allows for precise dissection and tumour removal. However, suturing up the kidney after the tumour has been removed can be challenging with the laparoscopic instruments.

da Vinci Xi 2021 at console

Robotic-Assisted Partial Nephrectomy

Robotic-assisted partial nephrectomy utilises robotic technology to perform the procedure through small incisions. The robotic system provides enhanced 3D visualisation, improved dexterity, and precise movements that facilitate complex reconstructions. Compared to laparoscopic surgery,the benefits of robotic surgery include the ability to safely excise tumours in challenging locations, and the robotic instruments enhance efficient suturing of the kidney after tumour removal. Studies show positive outcomes with robotic assistance, including reduced blood loss and shorter ischaemia times due to the ability to suture quickly.

da Vinci Xi 2021 beside

Technology & Equipment Used

Modern partial nephrectomy procedures employ various technologies to enhance safety and outcomes. Intraoperative ultrasound helps locate tumours and guide resection margins to ensure complete tumour removal. Specialised clamps temporarily stop blood flow to minimise bleeding during tumour removal. Energy devices assist in precise tissue dissection and bleeding control. Fluorescence imaging can also be used to visualise tumour margins and blood flow patterns during surgery.

Wondering which approach is right for you?

Dr Tan Teck Wei will assess your medical condition and recommend the most suitable technique.

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The Partial Nephrectomy Treatment Process

  • Pre-Treatment Preparation

    Before your partial nephrectomy, you will undergo comprehensive evaluation including blood tests to assess kidney function and overall health. Imaging studies such as CT or MRI scans provide detailed information about tumour size and location. You will need to stop certain medications, particularly blood thinners, as directed by your surgeon. Fasting is required for 6 hours before surgery. Arrangements for post-operative care and transport home should be made in advance.

  • During the Procedure

    On the day of surgery, you will receive general anaesthesia before the procedure begins. The surgical approach (open, laparoscopic, or robotic) will be performed as planned. The surgeon mobilises the kidney and identifies the tumour location, often using intraoperative ultrasound. Blood flow to the kidney may be temporarily clamped to minimise bleeding during tumour removal. The tumour is carefully excised with a margin of healthy tissue to ensure complete removal.

    The remaining kidney defect is repaired with sutures, and bleeding is controlled. The procedure typically takes 2-4 hours depending on tumour complexity and surgical approach.

  • Immediate Post-Treatment

    After surgery, you will recover in the post-anaesthesia care unit where you are closely monitored. A urinary catheter will be in place to monitor kidney function and urine output. Drainage tubes may be positioned near the surgical site to prevent fluid accumulation. Pain management begins immediately with medications adjusted to your comfort level. Most patients can begin drinking liquids once fully awake and progress to a regular diet as tolerated. Early mobilisation is encouraged, with assistance getting out of bed on the first post-operative day. The surgical team monitors for signs of bleeding or complications during this recovery period.

Recovery & Aftercare

  • First 24-48 Hours

    During the initial recovery period, pain management remains a priority with medications provided as needed. The urinary catheter typically remains in place for 1-2 days to monitor kidney function and ensure proper drainage. You will be encouraged to perform breathing exercises to prevent pneumonia and begin gentle movement with assistance. Vital signs and surgical drain output are monitored regularly.

    The surgical drain is usually removed after 1-2 days. Most patients can start a regular diet within 24 hours. Blood tests may be done to check the kidney function and ensure no significant bleeding has occurred. The surgical team watches for signs of complications while helping you progress toward discharge.

  • First Week

    Most patients are discharged home 1-5 days after surgery, depending on the surgical approach used. At home, you will need to care for your incision sites, keeping them clean and dry. Light activities are encouraged, but heavy lifting and strenuous exercise should be avoided. Pain typically improves during this week. Follow-up appointments are scheduled to check your wound. Watch for warning signs including fever, excessive bleeding, or severe pain and contact the clinic if these occur.

  • Long-term Recovery

    Full recovery from partial nephrectomy typically takes about 4-6 weeks. Most patients can return to desk work within 2-3 weeks, while those with physical jobs may need 4-6 weeks. Regular activities and exercise can gradually resume as comfort allows. Follow-up imaging is performed at intervals to monitor the remaining kidney and ensure no tumour recurrence. Kidney function tests will be done to confirm the preserved kidney is working well. Long-term surveillance continues with periodic scans and blood tests according to Dr Tan’s recommendations.

Dr Tan Teck Wei provides comprehensive post-procedure support to ensure optimal recovery.

Schedule your consultation to learn more about what to expect.

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Benefits of Partial Nephrectomy

Partial nephrectomy offers significant advantages for patients with kidney tumours. The primary benefit is preservation of kidney function, which becomes important for patients who may develop kidney problems later in life. Studies demonstrate that patients who undergo partial nephrectomy have lower rates of chronic kidney disease compared to those who have radical nephrectomy. This preserved kidney function translates to improved overall health outcomes and quality of life long-term.

The procedure provides equivalent cancer control to radical nephrectomy for appropriately selected tumours, meaning patients do not sacrifice cancer treatment effectiveness for kidney preservation. Patients maintain kidney function, which is valuable for those with diabetes, hypertension, or other conditions affecting kidney health. Should kidney problems develop in the opposite kidney later in life, having preserved kidney tissue from the partial nephrectomy provides functional reserve.

Risks & Potential Complications

Common Side Effects

Temporary blood in the urine (haematuria) occurs in most patients following partial nephrectomy and typically resolves within a few days. Post-operative pain at wound sites is expected and managed with appropriate medications.

Some patients experience temporary changes in kidney function as the remaining kidney adapts to the surgery. Fatigue is common during the recovery period as the body heals. Temporary digestive changes including constipation from pain medications and reduced appetite are normal and improve as recovery progresses.

Rare Complications

Though uncommon with experienced surgeons, potential complications include bleeding requiring transfusion or additional intervention. Urine leakage from the kidney repair site occurs in 1-5% of cases and may require additional procedures. Infection at surgical sites or within the urinary system is possible but can be reduced with the appropriate antibiotics. Rarely, loss of kidney function may occur if blood flow is compromised. Formation of arteriovenous fistulas or pseudoaneurysms are rare vascular complications. Hernias at incision sites may develop, particularly after open surgery.

Modern surgical techniques and experienced surgeons reduce complication risks. Pre-operative planning, careful surgical technique, and appropriate post-operative monitoring contribute to minimising potential complications and ensuring positive outcomes for patients.

Partial Nephrectomy Cost Considerations in Singapore

The cost of partial nephrectomy varies based on the surgical approach chosen, complexity of the tumour, and duration of hospital stay. Robotic-assisted procedures may have different cost structures compared to open or traditional laparoscopic approaches. The total cost includes surgeon’s fees, anaesthesia services, operating room charges, hospital accommodation, and post-operative care. Pre-operative imaging, laboratory tests, and pathology examination of the removed tissue contribute to overall expenses.

The value of kidney preservation through partial nephrectomy extends beyond immediate costs, potentially preventing future expenses related to chronic kidney disease or dialysis. Quality surgical care with an experienced urologist helps ensure positive outcomes and may reduce costs associated with complications or extended recovery periods. During your consultation, our team can provide specific information about expected costs based on your individual treatment needs and surgical approach.

Dr Tan Scrubs Photo

Dr Tan Teck Wei

MBBS (S’pore)

DFD (CAW)

MRCS (Edin)

MMed (Surgery)

FAMS (Urology)

Dr Tan Teck Wei is a Senior Consultant Urologist in Singapore who specialises in the management of complex urological cancers, including those affecting the kidneys, prostate, and bladder.

He is fellowship-trained in open, laparoscopic and robotic surgery. He also specialises in the management of other urological conditions including:

  • Prostate Enlargement
  • Recurrent Urinary Tract Infections
  • Stones

To date, Dr Tan Teck Wei has been involved in more than 500 robot-assisted surgeries, building up his volume of cases from his fellowship training days and cementing his expertise in robotic surgery.

Dr Tan Teck Wei believes in the holistic management of his patients, and seeks to journey with them from diagnosis to cure.  Dr Tan is effectively bilingual in English and Mandarin, making him a popular choice with the young and old, as well as international patients.

Dr Tan Teck Wei possesses a wealth of specialist experience in the field of Urology. He has previously held positions as a Consultant Urologist and Director of Genitourinary Oncology at Tan Tock Seng Hospital.

Dr Tan’s expertise in conducting MRI-targeted Prostate Biopsies led to his advisory role with the Ministry of Health’s Agency for Care Effectiveness. Furthermore, he has served as an Adjunct Assistant Professor and Clinical Teacher at the National University of Singapore (NUS) Yong Loo Lin School of Medicine and the Nanyang Technological University-Imperial College London’s Lee Kong Chian School of Medicine respectively.

He has actively participated in humanitarian initiatives as a member of the Singapore Navy surgical team, collaborating with the Indonesian Navy to provide healthcare services to the communities in Padang and Ambon. It is his passion to improve the standards of healthcare to patients both in Singapore and overseas.

  • Former Consultant Urologist and Director of Genitourinary Oncology, Tan Tock Seng Hospital
  • Adjunct Assistant Professor, National University of Singapore (NUS) Yong Loo Lin School of Medicine
  • Clinical Teacher, Nanyang Technological University-Imperial College London’s Lee Kong Chian School of Medicine
  • Advisor, Ministry of Health’s Agency for Care Effectiveness
  • Surgical Team, Singapore Navy
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Ready to Take the Next Step?

If you are considering partial kidney removal surgery, Dr Tan Teck Wei can help you understand if it is the right choice for your needs. With considerable experience in partial nephrectomy procedures, he provides personalised care throughout your journey.

Book Your Consultation Today
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    Frequently Asked Questions

    How long does partial kidney removal surgery typically take?

    Partial nephrectomy usually takes 2-4 hours, depending on the surgical approach and tumour complexity. Factors affecting duration include tumour size and location. Your surgeon can provide a more accurate estimate based on your specific case during the pre-operative consultation.

    Will I need dialysis after partial kidney removal?

    It is extremely rare for any patient to require dialysis after partial nephrectomy. The procedure preserves kidney function by removing only the diseased portion. Your remaining kidney tissue, combined with your other kidney, typically provides adequate function. Pre-operative kidney function tests help ensure you have sufficient reserve. Only patients with pre-existing severe kidney disease or complications affecting both kidneys might face a dialysis risk.

    What follow-up care is required after partial nephrectomy?

    Follow-up care includes an initial post-operative visit within 1-2 weeks to check the wounds and to review pathology results. Imaging studies (CT or MRI) are performed at regular intervals, typically at 3-6 months, then annually for several years to monitor for recurrence. Blood tests assess kidney function periodically. The surveillance schedule depends on tumour characteristics and pathology findings. Long-term monitoring ensures early detection of any new issues while confirming continued good kidney function.

    Can kidney tumours come back after partial nephrectomy?

    When performed with clear margins, partial nephrectomy has good long-term cancer control rates. Local recurrence in the operated kidney occurs in less than 5% of cases. Regular follow-up imaging helps detect any recurrence early when it is most treatable. Risk factors for recurrence include larger tumour size, aggressive pathology features, and positive surgical margins. Dr Tan will discuss your specific risk profile based on final pathology results and plan appropriate surveillance.

    What is the difference between partial and radical nephrectomy?

    Partial nephrectomy removes only the tumour and a small margin of healthy tissue, preserving the majority of the kidney. Radical nephrectomy removes the entire kidney, surrounding fat, and sometimes the adrenal gland. Partial nephrectomy is preferred when technically feasible because it preserves kidney function while providing equivalent cancer control for appropriate tumours. The choice depends on tumour size, location, patient factors, and surgeon expertise. Dr Tan will explain which option suits your situation.