PARTIAL NEPHRECTOMY

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Nephron-sparing surgery (NSS) has become a successful alternative treatment to radical nephrectomy for RCC.

Overview


(Robotic Partial Nephrectomy Performed by Dr. K. Ramesh – Apollo Hospitals Chennai India) Indications

  • Bilateral RCC (Renal cell Carcinoma)
  • RCC involving a solitary functioning kidney
  • Chronic renal insufficiency
  • Unilateral RCC with a functioning opposite kidney at risk for future impairment
  • partial-nephrectomy

Several studies have confirmed that NSS provides curative treatment that is as equally effective as radical nephrectomy in patients who have a

Adrenalectomy can be performed in two ways.

  • Single, small (< 4 cm in diameter)
  • Unilateral localized RCC.
  • NSS is also becoming increasingly recognized as effective treatment for small, select, incidentally discovered tumors, even when the other kidney is normal.
    The major disadvantage of NSS is
  • Small risk (1-6%) of local tumor recurrence due to undetected microscopic multifocal RCC in the remnant of the operated kidney
  • Risk of bleeding
  • Urine leak

Despite this higher complication rate, saving the normal nephrons in the kidney reduces the risk of impaired kidney function and its associated complications. Traditionally kidney tumors in the past were treated by complete removal of the kidney by open method. This involves a big cut and hospital stay of 7 days with severe pain and immobilization for a week.


This has been overcome by laparoscopic procedure were surgery is done by key hole method. Further to it now studies has shown that small kidney tumours can be removed by robotic method leaving behind the normal kidney. Robotic partial Nephrectomy (removal of kidney tumor alone) has both advantage of minimally invasive procedure and kidney preservation. It is the standard of care internationally. Robotic partial Nephrectomy is at present available at Apollo hospitals, Chennai. We have done multiple cases with good results in the last 6 months.


Advantages of Robotic Partial Nephrectomy over traditional open surgery.

  • less blood loss
  • less pain
  • short hospital stay
  • better tumor removal
  • good chance of preserving the normal kidney
  • less complications
  • better clinical outcome and cancer control
The Da Vinci System

Da Vinci Robotic systems ovecomes the traditional limitations of the open and laparoscopic surgery by Filtering and seamlessly translating the surgeon’s hand movements into precise micro-movements.

The System cannot be programmed and it cannot make decisions on its own. The da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon.

With da Vinci, small incisions are used to introduce miniaturized wristed instruments and a high-definition 3D camera. Seated comfortably at the da Vinci console, your surgeon views a magnified, high-resolution 3D image of the surgical site.