SURGERY FOR KIDNEY CANCER

Most kidney cancers grow as a single mass from the cells that line the miles of microscopic tubes coiled in each kidney. Surgeons traditionally treated kidney cancer by removing the entire kidney (a procedure called a nephrectomy) through a large open incision in the abdomen. Surgeons later began to remove kidneys using laparoscopy, operating through several small incisions in the abdomen. This approach is less invasive than open surgery, but the surgeon's dexterity, visualization, and fine hand control are somewhat limited. Today urologic surgeons can remove most small kidney tumors (those less than 4 cm in size) using a kidney-sparing approach. Surgeons remove the cancerous portion of the kidney and leave the normal, functional kidney tissue in the body.Dr.Vinay Mahendra at Apollo Multispeciality Hospitals,Kolkata is one of a few, highly experienced doctors in the world to offer this procedure routinely using the da Vinci robotic surgical system.

About Robotic Surgery for Kidney Cancer

The most advanced surgery for kidney cancer today, minimally invasive robotic surgery, incorporates the advantages of both open surgery and traditional laparoscopy. During minimally invasive robotic surgery the surgeon sits at a console next to the patient and controls four robotic arms. One arm holds a three-dimensional camera and controls its movements, while the other three hold miniaturized surgical tools, which precisely replicate the surgeon's hand and finger movements. The da Vinci robotic surgery system gives the surgeon a highly magnified view of the surgical field, and unsurpassed surgical dexterity and control.

Urologists have come to recognize that for many kidney cancer patients it is best to remove only the cancerous tissue and to preserve as much of the normal kidney tissue as possible – especially in patients who also have diabetes or high blood pressure, conditions that would put a lot of stress on the remaining kidney. In a partial nephrectomy surgeons remove only the diseased part of the kidney leaving patients with as much healthy kidney as possible. Several studies have shown that most people with kidney tumors less than 4 centimeters in size do best with a partial nephrectomy.

Minimally invasive robotic surgery allows the surgeon to perform all the steps of a partial nephrectomy – careful dissection, tumor identification and removal, and kidney reconstruction – with far greater precision, ease, and efficiency than conventional laparoscopy.

About Robotic Procedures for Kidney Cancer

Dr. Vinay Mahendra at Apollo Multispeciality Hospitals, Kolkata, pioneered and standardized the techniques now used for minimally invasive robotic kidney surgery (both radical nephrectomy in which the entire kidney is removed and partial nephrectomy, in which only the diseased part of the kidney is removed). In our experience, this procedure is the safest and most effective minimally invasive treatment for kidney tumors. Surgeons perform minimally invasive robotic kidney surgery through five or six tiny holes in the abdomen. Patients who undergo minimally invasive robotic kidney surgery have less pain, scarring, and fewer side effects than those who have traditional surgery. Our research, and that of other groups, has shown that cure rates after minimally invasive robotic surgery are similar to those of traditional surgery.

Partial nephrectomy allows surgeons to preserve as much normal kidney function as possible, lowering the risk of long term kidney failure, which can arise later in life from diabetes, high blood pressure, accidents, and other ailments. But a partial nephrectomy is a much more complex procedure than a radical nephrectomy, and takes longer to perform so there is a higher risk of complications such as bleeding, which can require a transfusion. There is also a small risk that the patients will form another tumor in the same kidney. In our experienced hands, these complications are low. Surgeons at only a few select centers can perform this operation safely. The Apollo Multispeciality,Kolkata Urology Robotics Team, led by Dr. Vinay Mahendra is one of the most experienced teams in minimally invasive robotic kidney surgery and we are leaders in this field of research.

Kidney Cancer