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Robotic surgery for kidney cancer

4th March 2013


Clinical research at NewYork-Presbyterian Hospital/Columbia University Medical Center is helping bring the advantages of robotic surgery, including reduced pain and quicker recovery, to kidney cancer patients.

Using the latest-generation da Vinci® S Surgical System by Intuitive Surgical, surgeons operate through several small incisions in the abdomen. Surgeons then remove only the cancerous tissue from the kidney, and repair the remaining normal kidney tissue, all using robotic arms guided by video taken by a camera controlled by a separate robotic arm.

The stereoscopic view provides enhanced visibility, and the nimble robotic mechanism makes for easy cutting and suturing, according to Drs. Ketan Badani and Jaime Landman, who make up the robotic kidney surgery team at NewYork-Presbyterian/Columbia.

"With robotics, there is a much greater opportunity for complex reconstruction of the kidney than can typically be achieved with a standard laparoscopic approach," notes Dr. Badani, director of robotic urologic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of urology at Columbia University College of Physicians and Surgeons.

"This means that, hopefully, we will have an opportunity not only to reduce the need for kidney cancer patients to require a kidney transplant, but also reduce their need for dialysis later in life," adds Dr. Landman, director of minimally invasive urologic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and associate professor of urology at Columbia University College of Physicians and Surgeons.

In a recent issue of the Journal of Endourology, Dr. Badani described a new technique for port placement -- the location of the small incision through which the robot operates -- that maximises range of motion for the robot's camera arm and working arm. The approach was shown to be successful in more than 50 cases, and has been adopted for use by medical centers worldwide.

Robotic surgery, most widely used for prostate cancer surgery, is beginning to be more widely available for other conditions. In addition to kidney cancer, Dr. Badani and Dr. Mitchell Benson (George F. Cahill Professor and Chairman of the Department of Urology at Columbia University College of Physicians and Surgeons and urologist-in-chief at NewYork-Presbyterian Hospital/Columbia University Medical Center), have established robotic surgery for bladder cancer, and they cite work being undertaken in pelvic floor reconstruction and repair of vaginal wall prolapse.





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