How robotic kidney surgery works

Kidney surgery is traditionally performed as an open surgery, which requires a large incision and possibly removal of a rib, which causes greater pain. Another approach, conventional laparoscopy, is less invasive, but limits the surgeon’s dexterity, visualization and control compared to open surgery. When performing a robotic kidney surgery, the surgeon sits at a console and controls the movements of miniature instruments and a tiny camera on the end of robotic arms inserted through several small incisions in the body.  The robot cannot be programmed nor can it make decisions on its own.  It is under the complete control of the surgeon at all times.

Precision: The movement of the surgeon’s hands is translated into precise movements of the miniature instruments within the patient.  The precision and dexterity of the robotic instruments make it an ideal system for kidney surgery, which requires great surgical skill for complex steps of tumor resection and kidney reconstruction.  Robotic assistance may allow patients with kidney tumors to receive a minimally invasive and kidney-sparing surgery who might otherwise require open surgery or total nephrectomy. 

3-dimensional optics: Standard laparoscopic surgery uses one single camera and limits a surgeon’s vision to a 2-D view similar to watching your television.  The robotic camera consists of two high resolution fiber optic camera which, like your eyes, produce a true 3-dimensional color picture available to the surgeon.  Magnification of up to 12X can be achieved with these cameras, whose position is precisely controlled using a central robotic arm.

Robotic surgery for kidney diseases is available from the world’s leaders in robotic surgery at Henry Ford’s Vattikuti Urology Institute (VUI).  VUI surgeons have done more robotic kidney surgeries that any other hospital in Michigan and are one of the highest volume robotic kidney surgery programs in the world.  Dr. Rogers routinely performs this specialized and complicated operation, utilizing advanced robotic surgical technology to provide a minimally-invasive surgical approach with greater surgical precision.

 

Advantages of Robotic Surgery

Minimally-invasive kidney surgery offers many potential benefits to the patient, including:

1. •Faster return of bowel function after surgery
   
   

2. •Reduced hospital stay (one day in healthy patients)
   
   

3. •Less postoperative pain and less need for pain medication
   
   

4. •Quicker return to normal activity and work
   
   

5. •Smaller incisions, less scarring, and faster healing
   

Types of Procedures Performed

Kidney surgeries performed with the daVinci Surgical System include partial nephrectomy, nephrectomy, nephroureterectomy, pyeloplasty, pyelolithotomy, adrenalectomy, and renal cyst decortication: 

1. •Robotic Partial Nephrectomy: Robotic surgery to remove the kidney tumor while preserving the normal and unaffected portion of the kidney, thus preventing the loss of the entire kidney. The kidney tumor must be cut out precisely to ensure complete removal.  The area of the kidney that has been cut out must be closed with complex surgical techniques. Robotic assistance can allow the surgeon to perform these complex steps with greater ease and precision. Robotic partial nephrectomy can provide a minimally invasive, kidney sparing option for kidney tumors, avoiding the potential need for a total nephrectomy or open surgery An advantage of removing only the tumor from the kidney instead of removing the entire kidney is that the patient will have more normal kidney remaining, with a lower chance of long term kidney failure, dialysis, or other medical problems. 
   
   

2. •Robotic Radical Nephrectomy: Robotic surgery to remove the entire kidney for large tumors or disease involving the entire kidney.
   
   

3. •Robotic Nephroureterectomy: Removal of the kidney and ureter for transitional cell carcinoma involving the kidney or ureter.
   
   

4. •Robotic Pyeloplasty: Repair of a blockage in the area where the ureter attaches to the kidney.
   
   

5. •Robotic Pyelolithotomy: Removal of large kidney stones that fail treatment by other methods
   
   

6. •Robotic Renal Cyst Decortication: Removal of kidney cysts that sometimes cause pain or high blood pressure
   

Retroperitoneal Kidney Surgery

Dr. Rogers is one of the few surgeons in the United States who routinely offers a robotic retroperitoneal approach for kidney surgery in select patients with prior abdominal surgery or tumors on the back side of the kidney. In this approach, the tumor is approached through small incisions through the patient’s side and back rather than through the abdomen, thus avoiding the abdominal contents.  The retroperitoneal approach is ideal for patients who may have internal scar tissue from previous abdominal surgery or who have tumors on the back side of the kidney that may be challenging to remove with an abdominal approach.

Want to know more?

Visit our Kidney Robotics FAQ page

Visit our page about Preoperative and Postoperative Instructions