Handling Kidney Cancer With One Tiny Incision

Anti-cancer kidney surgery can now be performed through a single belly-button incision as opposed to the usual six major cuts, doctors said in reports on two recent small studies. Fewer incisions have been shown to produce faster recovery and less pain. Working at the School of Medicine at the University of California at San Diego, the surgeons employed the technique called laparo-endoscopic single-site surgery (LESS). They demonstrated it is safe and effective to remove part or all of a kidney and to cut away tumors and blood clots from the main kidney vein.

“For advanced as well as localized kidney cancer, our surgical team has been able to reduce and consolidate the number of incisions to one port hidden in the belly button,” said Ithaar H. Derweesh, associate professor of surgery in the Division of Urology at UC San Diego Health System and Moores UCSD Cancer Center. “With one small opening to deploy instruments and remove diseased tissue, patients benefit from fewer complications, minimal opiate requirements, preserved quality of life, and excellent short-term outcomes.”
   
In order to confirm the results of these studies, Derweesh said, surgeons should conduct additional trials using much larger numbers of patients. The two studies’ results were published by BioMed Central Urology and Diagnostic and Therapeutic Endoscopy, both peer-reviewed, open-access journals.

“What we are seeing is that techniques such as LESS are more technically rigorous for the surgeon but infinitely better for patients,” said Derweesh, a member of the Center for the Future of Surgery at UC San Diego. “As our experience grows with single-port laparoscopy, we are committed to perfecting the operating tools and training new surgeons in these emerging techniques.”
   
The UC San Diego work is significant because kidney cancer is increasing worldwide, and is the most deadly of the common urologic carcinomas. In the United States, according to the American Cancer Society, the disorder is increasing at a rate of 2 percent to 3 percent per year, and is diagnosed in over 55,000 Americans annually.
   
The UC San Diego Health System’s surgeons have been pioneers in both scarless and single-incision surgery. Physicians at the UCSD Center for the Future of Surgery, performing an experimental procedure, were the first in the United States to successfully conclude an oral appendix removal.


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