Fox Chase Cancer Center researchers find that outcomes of robotic assisted kidney cancer surgery, when performed by experienced surgeons at high volume centers, prove more beneficial to patients when compared to open surgery. The study was authored by Fox Chase robotic surgeon Rosalia Viterbo, MD.
The standard treatment for kidney cancer is to surgically remove the entire or a portion of the kidney. This is known as nephron-sparing surgery, or partial nephrectomy, and is commonly performed using traditional open surgery. Recently, there has been interest in applying a laparoscopic approach for this procedure, however it has proven to be technically challenging to many surgeons.
Experienced laparoscopic surgeons at high volume centers, such as Fox Chase, are now using the da Vinciฎ robot assisted surgical system for patients with kidney cancer, or renal cell carcinoma. The advanced technology has enabled faster and greater technical proficiency allowing for completion of complex surgical procedures, facilitating a minimally invasive approach for partial nephrectomy.
"Our patients have experienced many benefits from the robot assisted approach, including shorter hospital stays (average 3 days), preserved kidney function (reduced need for dialysis), smaller scars with optimal cosmetic results, lower blood loss and easier and earlier return to normal activity," says Viterbo.
As a result of the fast recovery, patients do not delay the next step in their treatment plan, chemotherapy or radiation therapy, stopping the disease from progressing as fast. Similarly, patients with disease on both kidneys benefit because there is less waiting time between surgeries and there is no delay on further treatment. Again, this provides less opportunity for the cancer to grow and spread.
William Krassan came to Fox Chase after learning he had renal cell carcinoma in the right kidney and cystic renal cell carcinoma in the left. Using the da Vinci robot, Viterbo performed a partial nephrectomy on each kidney, just 8 weeks apart. This laparoscopic approach allowed the surgeon to reach the kidney through 4 tiny holes in the patient's abdomen. Open surgery would have required one large incision in his back and a longer time until the next surgery could have occurred.
"The procedure and recovery were fairly painless and easy," says Krassan. Dr. Viterbo did a wonderful job in an expeditious way. She was able to save 90 percent of my right kidney and two-thirds of my left kidney."
Viterbo added, "Results of the study show robot assisted partial nephrectomy to be a safe and technically feasible minimally invasive approach to kidney sparing surgery."
Robot Assisted Partial Nephrectomy: Oncologic and Nephron Sparing Outcomes. Moderated Poster Presentation was presented April 28, 2009.
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