New technique to remove kidney tumor better for patient
As a urologist I treat patients with kidney cancer. The treatment of this disease has changed radically in the past 20 years. The disease typically required removal of the entire kidney through a large incision that required 6 to 8 weeks to recover fully.
We then learned how to remove the kidney laparoscopically, using 3 or 4 1-inch incisions, which reduced the pain and recovery of surgery dramatically. It became apparent that removal of the entire kidney was not required to cure the cancer in most patients, and possibly risked long term kidney disease, so we devised a surgery to remove only the tumor. This operation, called a “partial nephrectomy,” was much more challenging to perform. But new technology such as the da Vinci robot made the surgery possible – and reduced the risk of long term kidney failure caused by removal of the entire organ. To perform that operation the entire blood supply to the kidney is clamped to prevent bleeding while the tumor is removed, but even this clamping causes damage to the kidney (just imagine holding your breath for 20 minutes!!).
So the most recent innovation is to clamp only the blood vessel that feeds the tumor instead of the entire kidney. This new technique was described for the first time in 2011 by world renowned surgeon and innovator Dr. Inderbil Gill at the University of Southern California.
Last Tuesday, I performed my first "super selective partial nephrectomy," using the techniques described by Dr Gill. The patient was unique in that the blood supply to her kidney was ideal for this approach and the tumor was small enough to remove without injury to the normal kidney. Like a typical laparoscopic case, we expect this patient to be home 2 days after the operation and back to normal activity in 2-3 weeks – with a totally uncompromised kidney to show for it.
Not every patient will be a candidate, but my team has shown that the procedure is possible and safe, and I expect this technique to become commonplace here at MultiCare.
Dr. Douglas Sutherland is a urologist with MultiCare Health System. He is the only fellowship trained urologist in Tacoma who specializes in minimally invasive urologic oncology. Reach him at 253-301-5100.
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