There is increasing evidence that small kidney tumors (< 4 cm) can be managed with active surveillance, especially in elderly patients with co-morbidities and in poor surgical candidates. The small kidney tumors may be monitored carefully with serial imaging. Alternatively, the tumor can be removed without removing the entire kidney. This is called a partial nephrectomy. This operation can be done as an open or a laparoscopic procedure. A laparoscopic partial nephrectomy (LPN) is usually done by a urologist who has advanced laparoscopic skills. Recently, LPN has been performed using the da Vinci robot. The operation is essentially the same. LPN has a higher risk of bleeding and urine leak compared to a laparoscopic radical nephrectomy (removal of entire kidney), hence it is not performed regularly.
Your urologist would determine if the kidney tumor is suitable for LPN after discussing with you and reviewing your ultrasound and CT scan.