There are two ways in which the nephrectomy can be done. The treatment approach and selection of the procedure depend on your health condition and the opinion of the surgeon.

Open nephrectomy:

1. The surgeon makes a cut in the abdomen or on the side of the abdomen (flank area).
2. A lower rib may need to be removed to perform the procedure.
3. As part of the procedure, the ureter (the tube that provides urine from the kidney to the bladder) and the kidney's blood vessels are cut away. The kidney is then removed. 
4. The incision (cut) is then closed with stitches.

Laparoscopic nephrectomy:

1. Your surgeon will make one or a few small incisions in your abdomen or side. 
2. They will insert a long wand with a camera (laparoscope) through the incision. 
3. They will view the image from the laparoscope on a large screen.
4. With the help of the camera image and small surgical tools, they will remove the diseased portion or the whole kidney. 
5. After that, your surgeon will close all the incisions with small stitches that will dissolve over time.

Investigations needed to be done before the surgery:

1. The preparation needs to be done by the donor to donate a kidney through a nephrectomy: To be considered a kidney donor, you must be in good health and free of diseases that might cause kidney failure. These diseases include diabetes and high blood pressure (hypertension). 
2. The blood type compatibility of a potential donor and recipient are first tested. 
3. The health care team will perform a series of other tests once blood type compatibility has been confirmed. These tests look for complications resulting in the recipient's body rejecting the new kidney. They also determine whether a potential donor has any health problems that would prevent them from being a successful donor.

Generally required investigations for a nephrectomy:

Your doctor will perform a blood test a few days before surgery. This test determines your blood type in case you require a blood transfusion, as well as your baseline kidney function and blood count.[5]

Anaesthesia: 

1. You will receive general anaesthesia during the surgery (medication to help you remain asleep) to ensure you don't feel anything.
2. You will receive instructions from your healthcare provider regarding how to prepare for kidney surgery. 
3. You should stop taking certain medications during the days before the operation, such as blood thinners. 
4. Your surgeon might also instruct you not to eat or drink anything during the night before your procedure.

You can expect the following:

1. You will be instructed about any medicines you will need to take on the day of surgery.
2. You will be admitted into the operation theatre and be informed about the procedure and the need to observe postoperative signs and symptoms.

You can expect the following:

1. You will not be awake during the entire surgery as general anaesthesia will be given to you.
2. You will be lie down on the operating table in a supine position (with your face and torso facing up).
3. After the procedure is completed, you will have a dressing over the wound. However, once it is clean and dry, you will no longer need dressing.