Robot-assisted Partial Nephrectomy

WHAT IS A ROBOTIC PARTIAL NEPHRECTOMY

Due to advances in Robotic technology surgeons are able to remove a portion of the cancerous kidney whilst sparing the remaining healthy part of the kidney. Dr Elmes utilises the advanced minimally invasive da Vinci Xi surgical system for removal of the cancerous mass. Robotic-partial Nephrectomy with the use of the da Vinci robot has excellent outcomes in terms of perioperative complications and functional results when performed by an experienced surgeon.

Compared to laparoscopic partial nephrectomy, Robotic Partial Nephrectomy has less chance of conversion to radical nephrectomy, less blood loss, precise tumour removal and kidney reconstruction, low rate of operative complications and shorter hospital stays.

The da Vinci robot used by Dr Martin Elmes.

The da Vinci system enables Dr Elmes to operate the robotic instruments in a full range of motions, transforming hand movements into corresponding movements of the surgical instruments within the patient. The da Vinci robot comprises the surgeon’s console and surgical cart. The surgical cart utilises one robotic arm to control the endoscopic camera that provides 3D vision, and three robotic arms to control surgical instruments. It is located next to the patient and allows the ability to rotate the instruments with unrivalled precision and control, using only a few small incisions. The robot only requires incisions of less than 1cm with one slightly larger to allow removal of the kidney cancer.

Partial removal made in the kidney of the cancerous mass.

The procedure initially involves Dr Elmes operating by the patient’s side to place the operating ports in the appropriate positions and dock the surgical cart of the da Vinci robot. Once the ports are placed and surgical cart docked Dr Elmes then sits at the robotic console and performs the operation, with an assistant surgeon at the patient’s side. All up the procedure may take a few hours and consists of removal of the kidney cancer and suturing up the defect, sparing as much normal kidney tissue as possible and then closing the small incisions. A catheter is placed through the urethra into the bladder and a drain is placed through one of the operating ports to the space outside the kidney to drain any blood or fluid that may accumulate after the procedure.