Removing Part of the Kidney
The robotic assisted laparoscopic partial nephrectomy technique is used to remove harmful kidney masses while trying to preserve as much healthy kidney function as possible. While not all kidney masses can be treated with this approach, it is an effort to maximize the overall patietn’s health while staying true to cancer treatment principles. Dr. Champ Weeks is one of the few surgeons utilizing the DaVinci surgical system ( www.intuitivesurgical.com ) to perform this minimally invasive procedure.
The procedure is typically performed through 4 small 1cm incisions in the abdomen. The abdomen is inflated with carbon dioxide gas to develop a large working space and the laparoscope provides excellent magnified vision in order to perform such a delicate operation. The kidney mass is exposed and seen under ultrasound guidance as well as direct visualization. The mass is removed safely and healthy uninvolved kidney tissue is left behind. Sometimes, the blood vessels to the kidney need to be controlled in order to minimize bleeding during the procedure. Sutures and special materials are used to control any bleeding of the remaining tissue. The mass is removed through one of the small incisions, the kidney is returned to its normal position. Occasionally, a temporary drain is left in place.
The patient experience will include the need for a gentle bowel preparation and clears liquids only for the day before surgery. The patient will be admitted on the day of surgery and expect a 2 to 3 hour operative time before being admitted to the recovery unit for observation. They may expect to usually go home within 1-2 days following the operation. Typically, there is minimal blood loss and minor discomfort during patient recovery. The patient can expect to be walking the same day as surgery and starting a regular diet within 48 hours after the operation.
The patient may drive two weeks after the surgery, return to work in 2 weeks and resume all normal activities, including heavy lifting 4 weeks following surgery after clearance from Dr. Weeks. Appropriate following up, including radiographic imaging will be set up on an individual basis.
Other accepted treatment options for kidney masses include total removal of the kidney, cryotherapy (freezing of the kidney mass), or RFA (radiofrequency ablation) or observation. All techniques can be performed through an open incision or via a laparoscopic minimally invasive approach. These techniques all carry different success rates, risks and benefits and will be discussed with Dr. Weeks in detail prior to anyone’s final decision for treatment.