A partial nephrectomy is the removal of a part of a kidney. It is often an effective and minimally invasive treatment for people with kidney cancer. It also leaves intact as much normal kidney tissue as possible.
With the use of the daVinci Robotic System, Swedish surgeons are able to perform this complex operation with greater precision than ever before.
In the videos below, Dr. Joel Lilly describes the robotic partial nephrectomy procedure and its benefits.
Partial nephrectomy is done in an operating room, with a specially trained surgical staff. Patients are under general anesthesia and are constantly monitored by an anesthesiologist.
During this procedure:
- The surgeon makes five small incisions in the abdomen, between one-third to one-half inch long
- Specially designed surgical instruments and an endoscopic camera are attached to robotic arms and precisely inserted through the incisions
- Once the instruments are safely in place, the surgeon then sits at a nearby console and controls every movement of the instruments
- The surgeon carefully moves other organs out of the way and controls the blood vessels that feed the kidney
- The area containing the tumor is isolated, and the tumor is carefully resected (cut away) from the kidney
- In the area where the tumor was removed, the kidney is repaired
- The tumor is put inside a sterile bag, and one of the incisions is enlarged just enough to remove it intact so it can be studied by a pathologist
- The instruments are removed, and the incisions closed
With the enhanced optics of robotic surgery, the surgeon is able to see everything magnified and in 3-D. The precision instruments allow for dexterity and control that mimics a human wrist.
This is a distinct advantage over standard laparoscopy, which uses a flat, 2-D screen and much less flexible surgical instruments.
Kidneys are located deep inside the abdomen, underneath the rib cage. When a patient has a large tumor – or one that has spread deeply into the kidney tissue – the entire kidney may need to be removed and/or an open procedure may be necessary.
Patients who have open procedures typically stay in the hospital three to seven days and take longer to recover. The surgery may require removal of part of a rib, which causes more pain.
In comparison, patients who have a robotic partial nephrectomy:
- Stay in the hospital one to two days
- Typically resume their normal activities within a few weeks
- Experience much less post-surgical pain due to smaller incisions and no rib removal
They may also have less blood loss during robotic surgery than with an open procedure.
All surgeries involve some degree of risk, and discussing this with your doctor is an important part of preparing for any surgery.
Complications associated with robotic surgery are about the same as for open surgery: The main risk is bleeding. The kidney has a large blood supply and surgeons work carefully to avoid excessive bleeding. It is also possible that the surgery may not remove the entire cancer and further therapy may be needed.
Robotic surgical systems are now widely available, but that does not mean every surgeon has the experience needed for positive outcomes. Kidney surgery, in particular, is very complex and requires extensive experience to be done well.
In talking with potential surgeons for your procedure, be sure to ask:
- How much robotic surgery experience they have
- How many robotic partial nephrectomies they have done
- How long robotic surgery has been available at the hospital
- How many partial nephrectomies are done there
Swedish is a regional center for performing – and teaching – robotic surgery. More than 4,000 robotic procedures have been performed here.
Many of our surgeons are among the most experienced in the country. They have published the results of their comparative research, and teach robotic methods to surgeons from other medical centers.