Robotic Partial Nephrectomy Saves Kidneys
Robotic partial nephrectomy is the “way of the future,” says Gerald Park, MD, a urologist with Kansas City Urology Care in the Northland.
“The mantra used to be to take the whole kidney. But in the last 10-15 years there’s been a paradigm shift away from open surgery toward laparoscopic surgery, with robotic surgery becoming more common in the last 5 years,” he explains.
Today when a small, early-stage renal tumor is detected, it is more likely to be removed through robotic partial nephrectomy, a procedure that has been Dr. Park’s area of focus for the past 8 years.
See Dr. Park’s PowerPoint presentation.
See Dr. Park perform partial nephrectomy surgery.
“Since the kidneys take 20 percent of the blood flow from the heart,” Dr. Park says, “it was difficult to do laparoscopic surgery due to the volume of blood loss – until robotics opened the door to partial nephrectomy.”
Robotic Partial Nephrectomy Surgery
A major advantage of the surgery is that it prevents the loss of the entire kidney while also preserving normal kidney function. “Studies have shown that the early-stage cure rate is the same, and there’s less chance of long-term kidney disease,” Dr. Park explains. “There’s been a realization that people can live longer with one-and-a-half kidneys.
“Other benefits are that minimally invasive surgery is less painful, causes less blood loss and has fewer complications,” he adds. “Hospital stays are shortened to two or three nights, and recovery is faster.”
Most renal tumors are now “incidentalomas;” found incidentally through CT or ultra-scans without clinical symptoms or suspicion. Dr. Park says. “Many are found in the ER when there’s belly pain or when gallbladder disease is suspected. Most of these masses are malignant, so even if they’re small, they should not be ignored. They should be evaluated by a urologist,” he advised.
Renal tumors do not respond well to radiation or chemotherapy, so robotic partial nephrectomy has become “the treatment of choice,” Dr. Park noted. “Patients tolerate the surgery better and they can have a great outcome. The cure rate in these cases is 90 percent.”
Robotic partial nephrectomy is usually recommended when the tumor is less than 7 cm and hasn’t spread. Location of the mass is also critical. Most peripheral renal tumors can be removed through laparoscopic surgery, he says, but “intrinsic tumors are more complicated to remove. A negative margin must be left around the tumor, which may not be possible if that area includes a renal artery or other major vessels.”
Dr. Park has performed hundreds of robotic partial nephrectomies, and currently performs 20 to 30 robotic surgeries a year at North Kansas City Hospital. In addition to renal cancer, he treats kidney stone disease, incontinence, prostate cancer and benign disease.
The American Urological Association and National Comprehensive Cancer Network provide guidelines and protocols for conducting renal surgeries, including robotic partial nephrectomies.
Physicians and patients welcome progress in renal cancer treatment. According to the American Cancer Society, “It is one of the ten most common cancers in both men and women.”
Gerald Park, MD
Dr. Park earned his MD from the University of Texas Medical Branch at Galveston and completed his residency at the University of Kansas Medical Center. He joined Kansas City Urology Care in 2000 and has been published in the Journal of Urology, and has presented scientific research at the American Urological Association national meeting. He has a special interest in robotic surgery and was the first surgeon north of the river to use the robot for surgeries of the kidney, prostate and bladder.
To learn more, call 816-842-6717.