Partial nephrectomy is also commonly known as nephron-sparing surgery or kidney-preserving surgery. During this surgery, the surgeon removes the abnormal lesion or kidney tumour and preserves the rest of the healthy kidney. This procedure is technically demanding and requires surgeons who have had dedicated training and previous experience.
Why should we consider Partial nephrectomy?
The main advantage of partial nephrectomy is preservation of kidney function, which may result in longer life span and better quality of life for the patients. Unfortunately partial nephrectomy is not always offered to patients due to several reasons such as lack of expertise in performing the procedure or the misconception that removing part of the kidney may not offer the same cancer cure rates. Several studies have confirmed that partial nephrectomy provides the same cancer outcomes compared to removing the entire kidney. However, not all patients may be suitable candidates for partial nephrectomy.
Which patients should consider partial nephrectomy over radical nephrectomy?
- Small kidney lesions (less than 4 cm)
- Prior history of cancer of familial disposition to renal cancers
- Pre-existing renal impairment
- patients with high blood pressure or diabetes who are at risk of developing renal in future
- prior history of renal stones
- Younger patients
What are the benefits of Robotic Partial Nephrectomy over Open Partial Nephrectomy?
Open surgery for treatment of kidney cancers often requires a large incision either in the flanks or abdomen. This is associated with significant pain and longer recovery time. Robotic surgery is performed via small keyhole incisions and subsequently patients experience lower pain, less bleeding and need for blood transfusion and faster recovery. Most patients will be discharged within 2-3 days after surgery and are able to resume normal activities within a few days following discharge from the hospital.
Robotic partial nephrectomy is a demanding procedure which requires dedicated training and experience. The hallmark of this operation involves achieving a negative margin of resection to maximise cancer outcomes and ensuring that there is no bleeding or leakage of urine after repair of the defect following resection of the cancer to minimise complications. Preservation of high volume of normal kidney while minimising the vascular clamp time are necessary factors, which maximise the preservation of kidney function. For this reason, urologists are often required to have additional training and practice to ensure optimal outcomes for their patients.
Dr Ahmadi underwent a dedicated 2-year robotic surgery fellowship and training under direct mentorship of Professor Inderbir Gill, a pioneer and the most experienced minimally invasive kidney surgeon in the world.