Robotic Radical Nephrectomy (Partial or Radical)

Overview of Robotic Radical Nephrectomy

A nephrectomy is a surgical procedure that removes all or part of your kidney. This procedure is performed to remove a diseased kidney (due to cancer, trauma or other disease) or to harvest a healthy kidney for donor transplant.

There are two kinds of nephrectomy:

• Partial: Only part of a kidney is removed, leaving healthy tissue intact.
• Radical/complete: The entire kidney is removed.

Loyola Medicine performs several different types of nephrectomy, including open, laparoscopic and robotic.

In a robotic-assisted (partial or radical) laparoscopic surgery, your surgeon uses robotic tools through small incisions, which allows for better imaging and precise removal of affected tissue.

Why Choose Loyola for Robotic Radical Nephrectomy?

Loyola is widely recognized as one of the top urology programs nationwide. Our multidisciplinary urologic cancer team is well versed in the recent advances in diagnosis, surgical procedures and treatment options that will allow many patients with kidney cancer to live with the disease and maintain normal schedules and lifestyles.

What to Expect with Robotic Radical Nephrectomy

Before surgery, the patient is placed under general anesthesia and a catheter will be placed to drain urine from the bladder. Depending on the size and location of the tumor and your condition, the surgeon will either perform a partial nephrectomy or a radical nephrectomy.

Robotic Partial Nephrectomy

In a partial nephrectomy (or kidney-sparing surgery), only the diseased part of the kidney is removed, leaving the healthy part in place.

The surgeon makes several small (laparoscopic) incisions in the abdomen from a remote control console next to the operating table. A telescopic lens is inserted into one of these small holes, enabling the surgeon to see a magnified, 3D view of the areas surrounding the kidney.

The abdomen is then filled with carbon dioxide gas to allow the surgeon to better see the operating area (this gas is removed at the end of the procedure).

They is able to precisely control movements of the robot’s surgical instruments to remove the tumor (and any surrounding lymph nodes) through intuitive technology that translates movements from his/her hand and wrist to the robotic instruments.

The surgeon will also temporarily cut off the blood supply to kidney, which will be restored after the diseased tissue is removed.

After the tumor is removed through one of the small incisions, the surgeon closes all incisions with sutures. He/she will also place a small drain around the surgical site. The total operating time is around three to four hours.

Robotic Radical Nephrectomy

This procedure is performed just like the partial nephrectomy surgery, but the surgeon will permanently (instead of temporarily) cut off the kidney’s blood supply and stop urine flow.

After inflating the abdomen with gas, the surgeon moves the colon away from the kidney and removes the kidney’s attachments to the liver, spleen, back muscles and adrenal gland. The entire kidney is then removed through one of the small incisions.

The robotic nephrectomy procedure typically results in less pain, scarring and blood loss, a shorter hospital stay (one to two days) and faster recovery time than traditional, open surgery. Patients are usually able to return to normal activity within two to four weeks.

Side Effects of Robotic Radical Nephrectomy

The short-term side effects of a partial or radical nephrectomy include:

• Blood clots
• Infection
• Nausea
• Fatigue
• Pain around the incision site or shoulder that can be managed with over-the-counter medication
• Breathing issues (your doctor will give you breathing exercises to prevent pulmonary infections)
• Reactions to anesthesia

Risks of Robotic Radical Nephrectomy

Depending on your condition and whether you have had a partial or radical nephrectomy, the associated risks of this surgery (and having less than two functioning kidneys) include:

• Poor kidney function due to limited blood flow
• Incontinence
• Bowel injury
• Damage to nearby organs, including the spleen, pancreas or liver
• Damage to the diaphragm
• Urinary fistula