Conditions

Treatment Options

Non-cancerous kidney conditions such as a kidney obstruction, also called blockage of the ureter, can usually be treated by removing the obstruction. Surgery to treat the condition (known as pyeloplasty) may be used depending on the type of blockage.

Kidney surgery can be performed using an open approach, meaning doctors must make a large abdominal incision. In fact, open surgery is the gold standard treatment for certain ureteral blockages. Another approach is conventional laparoscopic surgery. Laparoscopy is less invasive but limits the surgeon's dexterity, vision and control due to the instruments used during surgery.

da Vinci® Surgery for Kidney Obstruction

Radical nephrectomy is the surgical removal of the entire kidney. Depending on your disease state and tumor location, you may not have to lose your entire kidney to surgery. A surgical technique called partial nephrectomy aims to remove only the diseased part of your kidney and spare the healthy, functioning kidney tissue.

Sparing kidney tissue is important because studies show that patients who have their entire kidney removed are more likely to suffer from chronic kidney disease (CKD) after surgery than patients who received a kidney-sparing partial nephrectomy.² In fact, the American Urological Association states that partial nephrectomy is considered the treatment of choice for most T1 renal masses (small to medium-sized kidney tumors).³

Surgical Treatment Options

Thermal Ablation - An alternative therapy for kidney cancer is to use extreme temperatures. Cryotherapy freezes the tissue to kill cancer cells and radiofrequency uses heat to destroy cancer cells. Both methods use several tiny probes that are inserted into the kidney tumor either through an open or laparoscopic surgical technique. Thermal ablation therapy does not take the cancerous tissue out of the body, but rather uses probes to deliver extreme temperatures to tumors in the hopes that all cancerous tissue is destroyed.

An important note, studies show that patients treated with ablation (cryoablation or radiofrequency) had a significantly higher rate of recurrence – meaning the cancer returned – as compared to partial nephrectomy patients.⁴

Traditional Surgery - Kidney surgery is traditionally performed using an open approach, meaning doctors must make a large incision in the abdomen. Another approach is conventional laparoscopic surgery. It is less invasive, but limits the doctor's dexterity, vision and control, compared to open surgery.

With laparoscopy, the surgeon makes several small incisions, instead of the one large incision. The surgeon also uses telescoping equipment to view and remove the bladder. However, because of the long-handled instruments used in laparoscopic surgery, there are certain limitations during delicate or complex operations.

da Vinci Surgery for Kidney Cancer (Partial Nephrectomy) – The da Vinci Surgical System uses state-of-the-art technology to help your doctor provide the gold standard treatment, where indicated, and also perform a more precise operation. da Vinci offers several potential benefits to patients facing kidney surgery, including:

• Excellent clinical outcomes and cancer control⁵
• Short hospital stay⁶
• Low blood loss^5,6
• Precise tumor removal and kidney reconstruction^6,7
• Greater chance of preserving the kidney, in certain cancer operations⁷
• Low rate of operative complications⁷

This procedure is performed using the da Vinci Surgical System, a state-of-the-art surgical platform. By overcoming the limits of both traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for people around the world.

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient, condition and procedure. It is important to talk to your doctor about all treatment options, including the risks and benefits. This information can help you make the best decision for your situation.

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While clinical studies support the effectiveness of the da Vinci Surgical System when used in minimally invasive surgery, individual results may vary. There are no guarantees of outcome. All surgeries involve the risk of major complications. Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation. Surgery with the da Vinci Surgical System may not be appropriate for every individual; it may not be applicable to your condition. Always ask your doctor about all treatment options, as well as their risks and benefits. Only your doctor can determine whether da Vinci Surgery is appropriate for your situation. The clinical information and opinions, including any inaccuracies expressed in this material by patients or doctors about da Vinci Surgery, are not necessarily those of Intuitive Surgical, Inc. and should not be considered as substitute for medical advice provided by your doctor. © 2010 Intuitive Surgical. All rights reserved.

Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com

¹Kidney Cancer Association; Surgical Treatment; www.kidneycancer.org; URL: http://www.kidneycancer.org/knowledge/learn/surgical-treatment
²Huang WC, Elkin EB, Levey AS, Jang TL, Russo P; Partial Nephrectomy Versus Radical Nephrectomy in Patients With Small Renal Tumors-Is there a Difference in Mortality and Cardiovascular Outcomes; The Journal of Urology, Vol. 181, 55-62, January 2009
³American Urological Association; Guideline for Management of the Clinical Stage I Renal Mass; 2009; URL: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/renalmass09.pdf
⁴Kunkle D, Egleston B, Uzzo R; Excise, Ablate or Observe: The Small Renal Mass Dilemma – A Meta Analysis and Review. The Journal of Urology, Vol. 179, 1227-1234, April 2008
⁵Benway BM, Wang AJ, Cabello JC, Bhayani SB; Robotic Partial Nephrectomy with Sliding-Clip Renorrhaphy: Technique and Outcomes; European Association of Urology, Accepted December 28, 2008. Published online ahead of print on January 7, 2009
⁶Rogers CG, Menon M, Weise ES, Robotic partial nephrectomy: a multi-institutional analysis; J Robotic Surgery (2008) 2:141-143 DOI 10.1007/s11701-008-0098-2
⁷Bhayani SB, Das N., Robotic-assisted laparoscopic partial nephrectomy for suspected renal cell carcinoma. BMC Surgery 2008, 8:16 doi:10.1186/1471-2482-8-16.

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