What is robotic partial nephrectomy?
Robotic partial nephrectomy is a surgical procedure that involves the removal of a part of a diseased kidney using a surgical robot system (da Vinci surgical system).
It is a preferable treatment for small kidney tumors (< 4 cms). The non-diseased part of the kidney is spared in this procedure. In the case of large tumors of kidneys, radical nephrectomy is usually done, where the whole kidney is removed along with some surrounding tissues.
Alternative Name of Robotic Partial Nephrectomy
Kidney (nephron-sparing) surgery
Kidneys, adrenal glands.
How is robotic partial nephrectomy performed?
This procedure is done under general anaesthesia. The patient is positioned in a flank position (sideways) for better accessibility to the kidney region. Generally, 3-4 tiny incisions are made, and the abdomen is inflated using carbon dioxide gas for facilitating surgical movements and better vision. The surgeon on the console takes control and manoeuvres the movements, which are picked by robotic arms.
A 3D camera and surgical ports are inserted into the body at various marked areas for facilitating access to surgical instruments. The robotic-assisted surgical instruments excise the tumor along with other diseased tissues of the kidney. The tissues are then cauterized and sutured, all by the robotic system under the surgeon's control.
Preparation for the Robotic Partial Nephrectomy procedure
Before the procedure, all preoperative evaluations are done which include a series of tests like a complete blood profile, kidney function tests, imaging reports, and other additional tests.
The patients are asked to stop blood-thinning medications 7-10 days before the procedure. The patients are advised overnight fasting, similar to conventional surgical procedures. The patient is oriented about the surgical procedure a day before the surgery and other relevant information to make him easy and assured about the procedure.
Invasive surgical procedure
After completion of the surgery, patients are discharged after 1 or 2 days, depending upon the extent of the surgery. A follow-up appointment is fixed after 3-7 days to check for any problem associated with the procedure. A drain placed in the flank is also checked for the presence of blood or urine leakage. It is removed accordingly after the first assessment of the kidney's function. The doctor may advise you to conduct certain tests to check the kidney functional status. Pain-relieving medications and antibiotics are also prescribed for some days to curb pain and infection. Walking for a few minutes each day is also advised to keep the limbs working. This also helps in regaining full movements quickly.
Risks associated with robotic partial nephrectomy
The risks associated with robotic partial nephrectomy are usually less than other standard procedures. However, there are a few risks that also depend on the health of the patient. Some risks related to this procedure are:
- Post-operative pain: It is a usual complication that can be remitted by using painkillers.
- Post-operative infections: These can occur due to the presence of infection inside the kidney. Using broad-spectrum antibiotics can curb the chances of future infections.
- Gas and constipation: It occurs due to the effect of anaesthesia which goes on its own after some days.
- Risk of open surgery: In rare cases, the robotic partial nephrectomy procedure can be converted into open surgery.
Recovery from Robotic Partial Nephrectomy
The recovery from robotic-assisted nephrectomy takes 7-15 days, during which full bed rest is advised with limited body movements. Heavy lifting and driving are not advised for 2 months, which are also subject to other factors. An otherwise healthy person can return to normal activities within 3-4 weeks. A healthy diet with medications is advised till the last follow-up. It is advised to keep in touch with your doctors in case of any complications for their timely treatment.
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