Robotic Partial Nephrectomy

Robotic Partial Nephrectomy

Partial nephrectomy removes the cancer while preserving the normal and unaffected portion of the kidney,thus preventing the loss of the entire kidney.

Today, most kidney cancer patients have tumors that can be treated with a kidney-sparing approach. Our surgeons are among a select group of physicians in the world who regularly perform this specialized and complicated operation, using advanced robotic surgical technology through robotics. At Henry Ford, patients often can have a minimally-invasive and kidney-sparing approach. In most instances, the entire kidney does not need to be removed to treat the kidney cancer.

This treatment option does not increase the chance of recurrence (the cancer coming back) when performed by experienced surgeons on appropriately selected patients. This surgery is extremely complex. Most urologists are unable to perform this surgery because the surgeon must reconstruct the portion of the kidney which is left in the patient. After the tumor is removed, the remaining part of the kidney must be closed properly. Robotic surgery allows the surgeon to perform these complex steps with greater precision and accuracy.

How Partial Robotic Nephrectomy Works

1. In this surgery, the kidney is first identified and released from its surrounding structures. The blood vessels going to the kidney are identified, and the tumor is identified.

2. Blood flow then is stopped to the kidney using special vascular clamps. This is necessary in most cases, as the kidney will otherwise bleed if the blood flow is not temporarily stopped to the kidney.

3. The entire tumor is cut out of the kidney.

4 The kidney is reconstructed.

Kidney reconstruction is necessary to prevent bleeding after removal of the tumor. A variety of methods are used to reconstruct the kidney and sew it back together.

After the kidney is reconstructed, the blood flow to the kidney is restored by removing the vascular clamps which are on the blood vessels supplying the kidney. The kidney is inspected to ensure there is no bleeding from where the kidney was cut.Generally, the tumor is removed from the body through one of the laparoscopic incisions.

Because of the complexity of this surgery, patients may have a higher chance of postoperative complications from a robotic partial nephrectomy instead of a robotic radical nephrectomy, which is a removal of the total kidney.

Advantages

The major advantage of removing only the tumor from the kidney instead of removing the entire kidney is the patient will have more normal kidney remaining with a lower chance of long term kidney failure. Also, if something happens to the patient’s other kidney, the patient will still have one in reserve.

Complications

One disadvantage of a partial nephrectomy compared to a radical nephrectomy is that the procedure is much more complicated and it takes longer to perform. There may be a higher chance of complications, such as bleeding. Lastly, there is a small risk of reforming another tumor in the affected kidney.

Our Results

Henry Ford has excellent results with robotic partial nephrectomy. Henry Ford is one of the few centers in the world that routinely offer this procedure. Since most urologists cannot perform this operation skillfully, they often recommend removal of the entire kidney or a large and potentially painful incision (with rib removal) to perform a partial nephrectomy via an open surgery instead of laparoscopically.