Minimally Invasive Robotic Approach May Offer Partial Nephrectomy for More Kidney Cancer Patients

Urologists at Henry Ford Hospital have engineered a new approach that could make minimally invasive robotic partial nephrectomy procedures the standard, rather than the exception for kidney cancer patients. The technique spares the kidney, reduces long hospital stays and provides better patient outcomes by providing the surgeon with extra time to conduct the surgery.

Named ICE for Intracorporeal Cooling and Extraction, the technique may allow more kidney cancer patients to avoid invasive open surgery – now used in a vast majority of cases – along with its possible unwanted complications, including infection, blood loss, and extended hospital stays. The Henry Ford study was published in the journal European Urology.

In this latest study, Henry Ford surgeons employed robotic techniques to operate on seven kidney cancer patients between April and September 2012. For each case, they performed a partial nephrectomy, a procedure that involves removal of only the cancerous portion of the kidney.

Lead author, Craig Rogers, M.D., claims, "The study demonstrated that there's a two-pronged benefit. Our goal was to protect the kidney from damage during a minimally invasive partial nephrectomy, and from a cancer standpoint, we have the added security that we've removed more of the tumor."

Dr. Rogers states "What we've done is utilized a special type of device called a GelPoint trocar, that makes it easier to pass large things in and out of the abdomen through small incisions during minimally invasive surgery.”

"Through the gel point, we take a syringe that's been modified so we can pack and deliver ice through the body to the kidney. So when we clamp the blood supply to the kidney, it's packed in ice just as it would be in an open surgery.”

"Once the tumor is removed, instead of setting it aside in the body so you can sew up the kidney, we can remove the tumor as soon as it's excised through the gel point, look at it and decide if we're happy with what's been removed. If there's any doubt, I can go right back in and cut more out."

In the study, Dr. Rogers wrote that others have attempted several techniques to cool the kidney in minimally invasive surgery, however they "require specific equipment or expertise and are too complex or impractical for routine use."

Dr. Rogers concludes, "Unfortunately, the majority of people today diagnosed with kidney cancer get their entire kidney removed. Not only that, they're getting it removed through an open approach, though a large incision that often requires removal a rib, when there are minimally invasive approaches, such as robotic surgery, available."


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