robotic partial nephrectomy

introduction

Kidney cancer (renal cell carcinoma, RCC) accounts for 3% of all adult cancers. It occurs most commonly in the middle-aged patient with a male-female ratio of 2:1. In recent years with the advance of accurate, easily accessible scans (CT and ultrasound) these tumours are being picked up commonly as incidental findings during investigations for many other conditions.

Treatment for kidney cancer remains surgery. Previously, cancers like this involved removing the whole kidney, however, in recent years, it has been demonstrated that it is preferable to remove just the part of the kidney containing the cancer if the cancer is relatively small (i.e. under 4cm). This allows the patient to keep as much normal kidney function for the future as possible.

Robotic assisted laparoscopic partial nephrectomy is an extremely challenging technical procedure carried out in only a few centres in the UK. The key facts regarding this procedure are as follows:

  • The procedure has all the advantages of robotic surgery (see Overview)
  • Cancer clearance (i.e. complete removal of the cancer) can be achieved with excellent results in suitable patients
  • Robotic partial nephrectomy allows better recovery of the kidney function compared with other methods such as routine laparoscopic surgery. This is because the main blood vessels supplying the kidney are clamped for a shorter time during this surgery
  • Allows surgery on patients with a single kidney, thereby avoiding long term dialysis