Robotic Nephrectomy
Robotic Surgery to Remove a Kidney
A nephrectomy is an operation to remove a kidney. It may be recommended for some patients with kidney cancer when removing only the tumour while preserving the remainder of the kidney is not considered the most appropriate surgical option.
Where suitable, nephrectomy can be performed using a minimally invasive robotic approach rather than traditional open surgery.
Mr Neil Oakley has extensive experience in laparoscopic and robotic kidney surgery. Patients from Sheffield and South Yorkshire can have their consultation and assessment locally in Sheffield, with robotic kidney surgery undertaken in Manchester where appropriate.
What Is a Nephrectomy?
A nephrectomy is the surgical removal of a kidney.
For patients with kidney cancer, the extent of surgery depends on the characteristics of the tumour and the surrounding anatomy.
Where possible and appropriate, it may be preferable to remove only the tumour and preserve the healthy part of the kidney. This is known as a partial nephrectomy.
However, there are circumstances where removal of the whole affected kidney provides the more appropriate surgical treatment.
Find out more about Kidney Cancer
Why Might the Whole Kidney Need to Be Removed?
The decision to remove an entire kidney rather than perform a partial nephrectomy is based on the individual tumour and the patient's circumstances.
A complete nephrectomy may be considered when:
- The kidney tumour is large
- The tumour occupies a significant proportion of the kidney
- The tumour is situated deep or centrally within the kidney
- The tumour is closely related to major blood vessels or other important structures
- Preserving a safely functioning portion of the kidney would be technically difficult
- The characteristics of the tumour make complete kidney removal the more appropriate cancer operation
- The affected kidney already has significantly reduced function
The decision is not based on tumour size alone. CT or MRI imaging provides important information about the position and complexity of the tumour and helps determine the most appropriate surgical approach.
Can the Kidney Be Preserved Instead?
Preserving healthy kidney tissue is an important consideration when planning surgery for a kidney tumour.
A partial nephrectomy involves removing the tumour with an appropriate margin of surrounding tissue while leaving the remainder of the kidney in place.
For suitable tumours, this can provide effective surgical treatment while preserving functioning kidney tissue.
However, attempting partial nephrectomy is not appropriate in every case. The priority is to provide safe and effective treatment of the tumour.
Mr Oakley can review your scans and discuss whether kidney-preserving surgery appears appropriate or whether removal of the affected kidney provides the more suitable treatment.
Find out more about Robotic Partial Nephrectomy
What Is Robotic Nephrectomy?
Robotic nephrectomy is a minimally invasive or ‘keyhole’ approach to kidney removal.
The operation is performed under general anaesthetic. A camera and surgical instruments are introduced through a number of small incisions in the abdomen.
The surgeon operates using a robotic surgical system, which provides a magnified three-dimensional view of the operating area and articulated instruments that allow controlled movements within the body.
The robotic system does not perform the operation independently. The surgeon controls the instruments and makes all surgical decisions throughout the procedure.
What Happens During Robotic Nephrectomy?
During the operation, the kidney is carefully separated from the surrounding tissues and structures.
The blood vessels supplying and draining the kidney are identified and securely divided. The ureter, which carries urine from the kidney to the bladder, is also divided as required.
The kidney is then freed and removed. Although the internal part of the operation can be performed through small keyhole incisions, one incision needs to be enlarged sufficiently to allow the kidney to be safely removed from the body.
The removed kidney and tumour are sent to a specialist pathologist for detailed examination.
Radical Nephrectomy for Kidney Cancer
When complete kidney removal is performed to treat kidney cancer, the operation may be referred to as a radical nephrectomy.
The precise extent of surgery depends on the tumour and individual anatomy. In some circumstances, surrounding tissue may also need to be removed as part of the cancer operation.
Whether additional structures or lymph nodes need to be removed will depend on the clinical findings and will be discussed before surgery where relevant.
Why Use a Minimally Invasive Approach?
Kidney removal was traditionally performed through a relatively large open surgical incision. Minimally invasive techniques allow many nephrectomies to be performed through smaller incisions.
Potential advantages compared with traditional open surgery can include:
- Smaller surgical incisions
- Reduced post-operative discomfort for many patients
- Reduced blood loss in many cases
- Earlier mobilisation following surgery
- A shorter recovery period for many patients
- Magnified visualisation of the kidney and surrounding anatomy
Individual outcomes vary, and the most appropriate surgical technique depends on the tumour, the patient's health and other clinical factors.
Can You Live Normally With One Kidney?
This is understandably one of the most common concerns for patients who are advised to have a kidney removed.
Most people can live a normal life with one healthy functioning kidney. The remaining kidney is usually able to provide sufficient kidney function for the body's needs.
Before nephrectomy, kidney function is assessed and the appearance and function of the opposite kidney are considered as part of planning treatment.
Preserving kidney function is particularly important in patients who already have reduced kidney function or medical conditions that could affect kidney health in the future.
This is one reason why partial nephrectomy is considered where it can provide appropriate treatment while safely preserving healthy kidney tissue.
Looking After Your Remaining Kidney
Following removal of a kidney, maintaining general health can help protect the function of the remaining kidney.
Depending on your individual circumstances, longer-term care may include monitoring:
- Kidney function through blood tests
- Blood pressure
- Urine for signs of protein where appropriate
- Other medical conditions that can affect kidney health
Maintaining a healthy lifestyle, avoiding smoking and managing conditions such as high blood pressure and diabetes are important for general cardiovascular and kidney health.
Your clinical team can provide individual advice based on your kidney function and wider medical history.
What Are the Risks of Robotic Nephrectomy?
Robotic nephrectomy is a major surgical procedure and, as with any operation, there are potential risks and complications.
These can include:
- Bleeding
- Infection
- Blood clots
- Damage to surrounding organs, tissues or blood vessels
- Reduced overall kidney function
- Wound-related complications
- The need for additional procedures or treatment
- The possibility of conversion to another surgical approach if required for safety
There are also risks associated with general anaesthesia.
The likelihood of individual complications varies according to factors including the size and position of the tumour, previous abdominal surgery, general health and the complexity of the operation. These will be discussed as part of the consent process.
Recovery After Robotic Nephrectomy
Recovery following robotic nephrectomy varies between patients.
Early mobilisation is encouraged following surgery, and patients gradually increase their walking and general activity as their recovery progresses.
Some discomfort around the surgical incisions and increased tiredness are expected during the early recovery period.
Before leaving hospital, you will receive individual advice about:
- Looking after your surgical wounds
- Pain relief
- Walking and activity
- Driving
- Heavy lifting and exercise
- Returning to work
The time required to return to normal activities will depend on your individual recovery and the physical demands of your work and lifestyle.
What Happens to the Kidney After Surgery?
The kidney and tumour removed during surgery are sent to a specialist pathologist for examination.
The pathology report provides important information about the tumour, including its type, size and other characteristics. This information helps establish the final pathological stage of the cancer and informs subsequent follow-up.
The results will be reviewed with you following surgery and any implications for future surveillance or treatment will be discussed.
Follow-Up After Nephrectomy
Follow-up after surgery for kidney cancer is tailored to the individual patient and the final pathology results.
This may include:
- Clinical review
- Blood tests to monitor the function of the remaining kidney
- Follow-up imaging
- Blood pressure monitoring where appropriate
- Longer-term surveillance for kidney cancer
The frequency and duration of follow-up will depend on the characteristics and stage of the tumour and your individual circumstances.
Robotic Nephrectomy for Sheffield Patients
Patients from Sheffield, South Yorkshire and surrounding areas who have been diagnosed with a kidney tumour or kidney cancer can arrange a private consultation with Mr Oakley in Sheffield.
Your CT or MRI scans and other investigations can be reviewed to determine whether surgery is required and whether the kidney can potentially be preserved with partial nephrectomy or whether complete kidney removal is more appropriate.
For patients who proceed with robotic nephrectomy, appropriate consultation and pre-operative assessment can take place locally in Sheffield, with robotic surgery performed by Mr Oakley in Manchester using the da Vinci robotic surgical system.
Private Urology Consultations in Sheffield
Robotic Surgery for Sheffield Patients
Considering Surgery for a Kidney Tumour?
If you have been diagnosed with a kidney tumour or kidney cancer and would like to discuss whether partial nephrectomy or complete kidney removal may be appropriate, you can arrange a private consultation with Mr Neil Oakley in Sheffield.