Robotic Partial Nephrectomy

Overview

Robotic partial nephrectomy may be a beneficial surgical alternative for patients with kidney cancer. Robotic partial nephrectomy offers outcomes similar to traditional open and standard laparoscopic surgery, with reduced tissue trauma and risk of infection, less visible scarring and the potential for quicker recovery. Delicate, precise and rapid robotic suturing means kidneys spend less time diverted from the blood supply, which can contribute to preserved kidney function.

Mayo Clinic surgeons have many years of experience using robotic systems and have performed robotic urologic surgery since 2000. In 2002, Mayo surgeons began focusing more closely on refining robotic surgery for removing cancerous renal tumors; over 50 robotic partial nephrectomies are performed annually, and procedure volumes are expected to increase considerably as more surgeons are trained to use to the robotic systems.

In a robotic partial nephrectomy, the surgeon precisely identifies and removes portions of cancerous kidney tumors as well as surrounding healthy tissue through small (1- to 2-centimeter) abdominal incisions called ports (portals or keyholes).

Surgeons take advantage of the improved precision made possible by the computer-enhanced robotic system to perform complex procedures that can be challenging when performed using traditional surgical techniques.

During the procedure, the surgeon directs the movement of the surgical instruments from a remote console a short distance from the patient and operating table, while a surgical team stands by to assist. The surgeon sees a magnified, three-dimensional view of the surgical area on a video monitor. The enhanced image provides greater visual detail than traditional open surgery.

Another member of the surgical team stands at the operating table, closely monitoring the patient and the robot-controlled laparoscopic instruments. The assisting surgical team inserts the instruments through the abdominal incision ports and attaches the instruments to the system's robotic arms.

Robotic partial nephrectomy

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The surgeon sits at the console, directing the surgical instruments using two hand-and-finger control devices. The robotic system scales down the surgeon's hand motions, so larger original movements translate into a precise adjustment at the instrument's tip. The controls filter out minor tremors inherent to any human hand motion.

Partial nephrectomy incisions

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Robotic partial nephrectomy, laparoscopic partial nephrectomy, and traditional open surgery yield similar long-term outcomes. However, the much smaller incisions in robotic and laparoscopic surgery can mean less post-operative pain, tissue trauma, and blood loss and a faster return to normal activities. You can expect one to three days of hospital recovery following robotic laparoscopic surgery, as opposed to traditional open surgery, which usually requires a stay of up to five days.