Surgical Approaches for Kidney Cancer: Minimally Invasive Techniques and Robotic Surgery

Kidney cancer, commonly known as renal cell carcinoma (RCC), is a health risk affecting thousands worldwide. Some significant causes that lead to kidney cancer include high blood pressure, obesity, smoking, family history of the disease, and specific genetic conditions. The symptoms of this type of disease are blood in the urine, persistent back pain just below the ribs, fatigue, unexplained weight loss, and a lump or mass in the abdomen. It is essential to know that these symptoms might indicate other health conditions. Fortunately, advances in surgical procedures have revolutionised the treatment of kidney cancer, leading to better results for patients. In recent past, the emphasis has switched towards minimally invasive methods, such as laparoscopic and robotic-assisted operations, which offer significant advantages over traditional open surgery.

• Minimally Invasive Laparoscopic Surgery

Laparoscopic surgery is growing popular as a minimally invasive way to treat kidney cancer. Small incisions in the belly are made through which specialised equipment and a camera (laparoscope) are placed. The surgery is carried out as the surgeon watches a magnified picture of the surgical area on a monitor. This procedure has various advantages over open surgery, including less blood loss, shorter hospital stays, faster recovery, and better cosmetic results.

The tumour is removed during a laparoscopic partial nephrectomy while the remaining healthy kidney tissue is retained. This method is especially beneficial for individuals with tiny tumours or those who are at risk of developing chronic kidney disease. When the tumour is bigger or more aggressive, laparoscopic radical nephrectomy involves removing the entire affected kidney and surrounding tissues. However, both procedures provide effective cancer control while preserving kidney function.

• Robotic Surgery: Enhancing Precision and Dexterity

Robotic-assisted surgery is significantly a minimally invasive technique in treating kidney cancer. The most commonly used robotic platform, ‘The da Vinci Surgical System’, provides increased precision, dexterity, and three-dimensional visualisation. The surgeon directs robotic arms with small devices that accurately replicate their actions.

Compared to traditional laparoscopy, the robotic approach has significant benefits such as a secure camera platform, reduced tremor, and greater tool articulation that helps the surgeon identify and treat better. It also helps in precisely identifying and binding in complicated anatomical areas. Furthermore, 3D visualisation improves depth perception, allowing for more exact tumour identification and assuring optimal surgical results.

The Impact on Patient Care

Minimally invasive treatments, such as laparoscopic and robotic surgery, have revolutionised the treatment of kidney cancer. These methods offer patients various advantages, including fewer side effects, scarring, shorter hospital stays, faster recovery, and a faster return to everyday activities. Maintaining the kidney’s health is crucial, especially for individuals with pre-existing kidney diseases or at risk of developing kidney damage.Furthermore, the benefits of minimally invasive methods go beyond patient comfort and recovery. Reduced blood loss during surgery results in lesser transplants, reduced risks, and greater overall outcomes.

When choosing the best surgical method, factors such as tumour size, location, and individual patient characteristics should be carefully considered. Lastly, with the development of minimally invasive techniques and robotic surgery, surgical approaches for kidney cancer have seen great progress. These innovative approaches have transformed how kidney cancer is treated, bringing several advantages.

By Dr. Shishir Shah, Surgical Oncologist, HCG Cancer Centre, Vadodara