Benefits of Nephron-Sparing Surgery (Partial Nephrectomy)
Improvements in imaging technology have made it easier for doctors to identify kidney tumors earlier. This is an important advancement, as research shows that smaller renal masses are 20 to 25 percent more likely to be benign (non cancerous). Early kidney tumor detection also means it is more likely that the patient may be a good candidate for a partial nephrectomy, or nephron-sparing surgery.
In the past, all renal tumors were treated by removing the entire kidney through a surgery called a radical nephrectomy. Unfortunately, patients who have their entire kidney removed are predisposed to developing chronic renal disease.
Nephron Sparing Surgery Reduces Risk of Chronic Renal Disease
Studies have shown that nephron-sparing surgery minimizes a person’s risk of developing chronic renal disease. In fact, the American Urological Association considers a partial nephrectomy the treatment of choice for most small to medium-sized kidney tumors (T1 renal masses, generally 7 cm or smaller).
Partial Nephrectomy Surgical Options
There are three common surgical options for patients needing a partial nephrectomy:
- Open partial nephrectomy (traditional surgery)
- Laparoscopic partial nephrectomy
- Robotic partial nephrectomy
Both the laparoscopic and robotic partial nephrectomy are minimally invasive surgeries. Robotic partial nephrectomies, however, have some important benefits over laparoscopic and open surgery:
- Excellent clinical outcomes and cancer control
- Short hospital stay
- Low blood loss
- Precise tumor removal and kidney reconstruction
- Greater chance of preserving the kidney, in certain cancer operations
- Fewer surgical complications
Dr. Ali Sarram, a board-certified urologist, was one of the first urologists in Denver to perform a partial nephrectomy using robotic-assisted surgery back in 2005. He has extensive experience in using the surgical robot to remove complex renal masses, and he has performed more than 100 partial nephrectomies using minimally invasive techniques.
"Using robotic technology, I have been able to do some complicated surgeries in patients who would have otherwise lost their kidneys," explains Dr. Sarram.
Robotic Partial Nephrectomy: What to Expect
The surgeon sits at the console and views a magnified, 3D-image of the surgical site on a computer screen in real-time. The robot has a high-resolution camera and four arms equipped with miniature instruments referred to as micro instruments.
Through small incisions, the surgeon uses the micro instruments to access the kidney. The robot senses the surgeon's hand movements and translates them electronically into precise movements for the micro instruments. It also detects and eliminates any tremors in the surgeon's hand movements.
The robotic micro instruments can rotate 360 degrees, providing the surgeon a much wider range of mobility than with the human hand and traditional surgical tools.