Robotic Partial Nephrectomy to Remove Kidney Masses
A partial nephrectomy is the removal of part of the kidney due to disease including tumors or cancer. Partial nephrectomies can be performed in an open or laparoscopic manner, however Dr. Engel prefers the robotic approach in most cases.
In general, we seek to perform a partial nephrectomy rather than a complete or radical nephrectomy whenever possible. A partial nephrectomy is on occasion performed as an open case through a large incision, as with solitary kidneys or high risk cases, but in general Dr. Engel will perform this surgery laparoscopically. On occasion, hand-assisted laparoscopy is used; other cases will require only simple laparoscopy. However, the majority of partial nephrectomies involve robotic surgery. Regardless of the method of surgery, Dr. Engel would prefer not to clamp the renal (kidney) blood vessels to do this, many cases require it due to the location, size or depth of the tumor involved. In these cases, a standard robotically assisted laparoscopic partial nephrectomy is performed where the vessels are clamped.
Scroll down to view operative video
In the video below, the complete laparoscopic dissection of the kidney, and the tumor, as well as the laparoscopic ultrasound routinely performed to locate the tumor and plan the resection is not shown. Dr. Engel does not utilize robotic surgery for these steps. The video commences upon clamping the renal vessels, after which time limited time is available to perform the resection without damaging the kidney.
This video represents an actual Robotic Partial Nephrectomy
Warning – content is graphic
Partial Nephrectomy Recovery & Aftercare
All patients undergoing laparoscopic kidney surgery will have undergone a full bowel prep. Patients undergoing a partial nephrectomy can expect to be in the hospital for three days, with the main complications that can occur being bleeding from the kidney or urine leaking from the resection site. All patients undergoing laparoscopic surgery are subjected to a very small risk of inadvertent bowel or vascular injury that may require repair.
A stent is placed from the bladder to the kidney during the surgery so blue dye can be injected after the tumor is resected to show any possible urine leaks at the time of surgery. The stent is typically removed before the patient wakes up.
Patients will follow up with Dr. Engel in two weeks to review the pathology report, and are typically recovered by that time. The hallmark of proper recovery here, as with all laparoscopic surgeries, is that the patient must feel better each day. Fevers or nausea and vomiting should always be taken seriously and if observed in the first two weeks will necessitate going immediately to the George Washington Emergency Room to be evaluated.