Transcript of Video
I’m Rusty Libby with Northwood Urology of Texas. And today we’re gonna be talking about retroperitoneal robotic partial nephrectomy. Some of the patients that I see in clinic come in with kidney cancer. There’s different types of kidney cancer but often the kidney cancer is located on the back of the kidney, which sometimes presents an issue accessing the tumor to remove it.
Now, if you come to see me and you are an acceptable candidate for surgery, what we can do is sit down and talk about your specific kidney cancer, where it’s located, and what best approach we should use to get rid of it. If you’re found to have a tumor on the back of your kidney and we’re considering removing part of your kidney, there’s a special procedure that can be done called a robotic retroperitoneal partial nephrectomy. It’s a fancy name, but I’m gonna describe it to you so that you can understand it in better detail.
Well, it’s a robotic procedure, meaning I use the Da Vinci Xi robot. It is retroperitoneal, all that means is that it’s outside of the abdominal cavity. We can actually dilate a space, a potential space with a balloon, and then use CO2 to keep that space open. We can dock a robot and then I can operate from a console, moving instruments inside the body to gain access to the important parts of the kidney needed to remove part of the tumor that sits on the kidney. The first thing that happens is you come into the operating room and you go to sleep. I’ll then reposition you on your side. And then we can get access from the side by dilating a space with a balloon, pushing the kidney up, which gives us access to the blood vessels to the kidney. At that point, we can put a vessel loop around the renal artery and identify any anatomy that needs to be identified prior to locating the tumor.
After we locate the tumor, we’ll clear it off. We’ll mark the margins of the planned cutting to cut out the tumor. We’ll clamp the artery to the kidney and then we’ll cut the tumor out after which there’ll be a little bit of bleeding but we can oversew this with some sutures and get the bleeding to stop. Then we take the clamp off of the artery and repair the kidney. This is a great approach for tumors located on the backside of the kidney. It can be used for anterior or tumors on the front side of the kidney, but especially for those tumors on the backside, it gives us direct access.
I wanted to talk about this because the retroperitoneal approach, the approach where you don’t have to go through the abdomen, is not commonly done but when it is done, I do believe it is a superior approach to kidney surgery. The reason why is this, if you don’t go into the abdomen, you’re not going to be disturbing the bowels. And that means that when you recover from the surgery, you’re not gonna have as delayed of a recovery for your bowels to wake up which means you could eat sooner, you’ll have less abdominal pain, and you can often go home from the hospital earlier.
So I just wanted to spend a minute talking about the retroperitoneal approach to doing robotic surgery in this case, to remove parts of kidneys. Thanks for watching. I’m Russell Libby with Northwood Urology of Texas. And if you can visit us online at northwoodurology.com or give us a call at 404-3000, we’d be happy to make an appointment to see you, thank you.