Modern Kidney Cancer Surgical Procedures

 

There are two main types of surgery for the treatment of kidney cancer: partial nephrectomy and radical nephrectomy. A partial nephrectomy is a procedure that involves removing a part of a kidney, while a radical nephrectomy is a surgical procedure that involves removing the whole kidney.

Surgical procedures can remove:

  • Cancer cells that are growing inside the kidney (early stages of kidney cancer).
  • Cancer growths that have spread to surrounding tissues (locally advanced kidney cancer).

The aim of surgery is to eliminate all can cancer cells to cure the disease. If the surgeon is able to remove all cancerous cells, kidney cancer can be cured. However, in some cases, it might not be possible for a surgeon to remove all cancerous cells, but surgery can still control the growth of the cancer and relieve symptoms.

Partial Nephrectomy

This surgical procedure is typically recommended for small kidney cancer that has not yet spread to surrounding tissues. It is used to treat most cases of stage 1 kidney cancer. Stage 1 cancer means cancerous growths measure under 7cm in length.

During the procedure, the part of the kidney that contains cancerous cells is removed. A large section of the kidney remains. The medical term for the procedure is nephron-sparing surgery, as the nephron is a key filtering component in a kidney and it needs to be left to ensure the kidney can still function after surgery.

There are some instances in which partial nephrectomy surgery is not suitable for the treatment for small kidney cancer due to the position of the cancerous cells within the kidney.

Radical Nephrectomy

During a radical nephrectomy operation, the whole kidney is removed as well as the surround tissues, such as the adrenal gland. The surgeon may also remove lymph nodes from the area.

A radical nephrectomy is major surgery, but providing the cancer hasn't spread, patients will not require any further treatment.

Palliative Nephrectomy

A palliative nephrectomy operation is kidney surgery to manage symptoms. The procedure is unlikely to completely cure the cancer, but it can relieve symptoms, such as bloody urine and pain, and make patients more comfortable.

A cancerous tumour in the kidney can release cytokines into the bloodstream. These chemicals can cause a range of unpleasant symptoms, such as sickness and drowsiness. Removing a cancerous tumour from the body can reduce, or in some cases, eradicate those symptoms.

The complete removal of a cancerous kidney is also often recommended to slow down cancer growth in order areas of the body. A kidney surgery specialist will be able to inform patients as to which type of operation will provide the best results.

Keyhole Surgery

In some cases, surgeons can remove an entire kidney or part of it via laparoscopic kidney keyhole surgery, which involves making multiple small incisions in the abdomen as opposed to one large incision. Keyhole surgery is also called laparoscopic surgery.

During keyhole surgery, a surgeon uses a medical instrument called a laparoscope. The device looks a bit like a mini telescope. It has a camera at one end and a light at the other to enable the surgeon to see inside of the body.

A kidney cancer keyhole surgery procedure will typically involve the surgeon making multiple small cuts in the tummy areas. Various instruments can then be inserted through those cuts, including the laparoscope. Surgeons can see what they are doing inside of a patient's body by looking at a monitor.

A typical keyhole surgery patient will end up with around 4 small scars, spanning about 1cm in length.

Robotic Surgery

When it comes to modern kidney cancer surgical procedures, some of the most advanced hospitals have robots to control the laparoscopic instruments during keyhole surgery. Robotic surgery is certain to become more mainstream around the globe and possibly automated thanks to AI in the future.

During robotic kidney surgery, a machine with 4 arms is used. One arm holds the camera, while the others hold various surgical instruments

The surgeon has to make the initial cuts in the abdomen to place the camera and instruments through. The surgeon then uses a computer to control all of the robotic arms and complete the operation. The latest technology allows for a 3D, magnified view of the treatment area.

In the United Kingdom, robotic keyhole kidney cancer surgery is mainly carried out in specialist cancer hospitals. The surgery is also referred to as da Vinci surgery or robot-assisted surgery.

Pros And Cons Of Laparoscopic Surgery

keyhole operations have different benefits and risks to open surgery.

The main benefits of keyhole surgery are:

  • Less painkilling medication required after the procedure.
  • Faster recovery times.
  • Patients can leave hospital more quickly.

The drawbacks of laparoscopic surgery are:

  • Procedure can take longer than open surgery, meaning patients can be under anaesthetic for longer periods.
  • If complications arise, such as difficulty controlling bleeding, the surgeon may have to resort to open surgery.

All kidney cancer patients are provided with a detailed rundown of the risk and benefits of laparoscopic surgery, so they can make the most informed choices for their cancer treatment plan.