Robotic partial nephrectomy is surgery done to remove a portion of a kidney and treat cancer, attempting to preserve as much healthy kidney tissue as possible.
Who Needs Robotic Partial Nephrectomy?
The procedure may be a good option for patients with a small kidney tumor and when it is feasible to leave behind the healthy portion of the kidney without cancer. Preserving kidney function has many long-term advantages including increased longevity, decreased risk of high blood pressure and reduced risk of kidney failure and need for dialysis.
Advancements in surgical procedures have made robotic partial nephrectomy the preferred surgical treatment option for patients with kidney tumors less than four centimeters in size. Tumors between four and seven centimeters may be treated with robotic partial nephrectomy if they are located in favorable areas.
Potential Risks of Surgery
After surgery, there is a possibility patients may experience the following side effects:
- Excessive bleeding, requiring blood transfusion
- Urinary leak around the kidney
- Risk of superficial skin infection
Risks of general anesthesia include sore throat, changes in blood pressure, reactions to medicines used in anesthesia and lung infection. In some instances where the kidney cancer cannot be safely removed through miniaturized instruments, the doctor may need to convert to open surgery.
How to Prepare for Surgery
Patients taking blood thinners such as warfarin, Eliquis or plavix will need to stop taking them five to seven days before surgery. Patients will need to inform their surgeon and anesthesiologist of any medication and supplements they may be taking.
Tobacco products negatively impact the body’s natural ability to heal after surgery and patients will need to stop smoking before surgery.
Patients will be instructed to avoid eating or drinking anything after midnight the night before surgery to prevent unpleasant side effects associated with anesthesia, such as nausea. However, patients may take blood pressure medicine the morning before surgery with a small sip of water.
What to Expect During Surgery
The procedure will begin once the patient is under general anesthesia. The surgeon will make small incisions in the abdomen where the surgical equipment and camera will be inserted. The abdominal cavity will then be inflated with carbon dioxide gas to create space for surgical equipment and the camera to maneuver and access the treatment area.
Blood flow to the cancerous kidney will be stopped so that the kidney can be dissected. The cancerous portion will be removed from surrounding tissue and the remaining section of the kidney will be sewn back together.
The Recovery Process
After the procedure, patients will be closely monitored with blood tests and imaging. The procedure is far less disruptive than open surgery, and pain can often be controlled without narcotic pain medications.
Patients will be instructed to walk for brief periods of time to support healing, blood flow, and normal functioning. Walking also helps prevent pneumonia and other complications.
Immediately after surgery, patients will briefly be placed on a liquid diet and given solid food diet as soon as they are able to tolerate it. To support full recovery, patients will need to eat a healthy diet, exercise, and have regular checkups.