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Newest Surgical Option for Kidney Cancer
The newest surgical option for localized kidney cancer – using robotic technology to remove the tumor and spare the kidney – will be featured in a Wake Forest University Baptist Medical Center webcast.
The webcast will feature Ashok K. Hemal, M.D., M.Ch., professor and director of the Robotic and Minimally Invasive Surgery Program of the Department of Urology, performing robot-assisted, kidney-sparing surgery on a 48-year-old man with kidney cancer. Karim Kader, M.D., Ph.D., assistant professor of urology, will moderate.
“Kidney function is closely linked to overall health and life expectancy,” said Hemal, who specializes in treating cancer of the prostate, kidney and bladder with robotic and laparoscopic surgery. “In the past it was common to remove the entire kidney and the adrenal gland in cases of localized kidney cancer. But today, we work to preserve the part of the kidney unaffected by cancer.”
Most cases of kidney cancer are diagnosed in people over age 50 and involve tumors originating in the lining of small tubes in the kidney that filter the blood and remove waste products. There are often no symptoms, but when symptoms do occur, they can include blood in the urine, back or flank pain, weight loss and anemia. Because of the increasing frequency of diagnostic procedures today, many cases of kidney cancer are discovered when doctors are looking for something else, such as gallbladder problems. That means most cases of kidney cancer are found early, before the cancer has spread.
“With early detection of kidney cancer, there is a 95 percent chance of cure, which allows us to give patients peace of mind,” said Kader.
Early detection also allows surgeons to remove the tumor and spare healthy kidney tissue, which sharply decreases the risks for long-term kidney failure or impairment and improves overall survival. It has also been shown to decrease the risks of heart attacks, strokes, hypertension, diabetes and the need for dialysis or transplant.
“In spite of its advantages to the patient, kidney-sparing surgery is significantly underused,” said Kader. “Between 1988 and 2002 in the United States, only 20 percent of smaller tumors were treated with partial removal of the kidney.”
Hemal explained that kidney-sparing surgery originated when the only surgical option was a traditional operation with a large incision. Newer, minimally invasive surgical options have been developed, such as laparoscopic surgery and robot-assisted surgery, which require only small incisions and reduce recovery times. However, these minimally invasive procedures are more technically challenging when it comes to kidney-sparing surgery, so are offered primarily at high-volume centers.
“Benefits of the minimally invasive approaches include less pain and blood loss, a shorter hospital stay, and a quicker return to work and other activities,” said Hemal. “Most patients are back to their normal routines within two weeks.”
Wake Forest Baptist urologic surgeons offer renal sparing surgery whenever possible and generally perform these operations with robotic technology.
With robot-assisted surgery, the surgeon controls four “arms” that have centimeter-size instruments attached. The tiny instruments – as well as the ability to see the surgical site at 15-fold magnification on a screen – allow for very precise, refined movements. Hemal said the three-dimensional view, precision and dexterity allow an experienced surgeon to use the technology for kidney-sparing procedures.
“Robot-assisted surgery offers the best of both worlds,” said Hemal. “It offers patients the benefits of minimally invasive surgery and allows their healthy kidney tissue to be spared.”
