da Vinci® Partial Nephrectomy (Kidney-Sparing Surgery)
Finding out you have a serious kidney problem may be one of the hardest things you’ve faced. That’s why it’s important to learn about your options before choosing the best path forward.
Know Your Options
If your doctor suggests surgery for a kidney disease or kidney cancer, it can be done using open surgery through one large incision (cut) or using minimally invasive surgery – through a few small incisions – with traditional laparoscopy or da Vinci Surgery.
Depending on your condition and the location of your tumor, you may not have to lose your entire kidney during surgery. This surgical method is called partial nephrectomy or kidney-sparing surgery. The goal is to take out only the diseased part of your kidney and keep the healthy part in place.
Why da Vinci Surgery?
The da Vinci System is a robotic-assisted surgery device that your surgeon is 100% in control of at all times. The da Vinci System gives surgeons:
- A 3D HD view inside your body
- Wristed instruments that bend and rotate far greater than the human hand
- Enhanced vision, precision, and control
da Vinci Partial Nephrectomy offers the following potential benefits compared to open surgery:
- Shorter hospital stay1,2
- Less pain 2,3,4
- Less blood loss 2,5
- Fewer complications 1,2
- Smaller incisions for less scarring
da Vinci Partial Nephrectomy offers the following potential benefits compared to traditional laparoscopy:
- Shorter warm ischemic time (shorter is better for kidney function)6,7
- Less blood loss 6,8,9
- Shorter hospital stay 10,11,12
- Fewer complications 6,7
- Similar positive surgical margin rates *2,12,16,17,18,19,20
- Better renal (kidney) function rate12,13
- Also, studies show patients who have kidney-sparing surgery (partial nephrectomy) are less likely to suffer from chronic kidney disease (CKD) or need dialysis compared to patients who lose their entire kidney.14,15
The da Vinci System has brought minimally invasive surgery to more than 3 million patients worldwide. da Vinci technology – changing the experience of surgery for people around the world.
Risks & Considerations Related to Nephrectomy (kidney removal): poor kidney function often due to limited blood flow, leaking of urine, cut or tear in the spleen, pancreas or liver, bowel injury, trapped air between the chest wall and lung, injury to diaphragm (muscle separating the chest from the abdomen), urinary fistula (abnormal bond of an organ, intestine or vessel to another part of the body), abnormal pooling of urine, limited or cut off blood supply to kidney, abnormal pooling of lymph fluid.
* Surgical margin: Surrounding tissue that is removed with the tumor. If cancer cells are found in this tissue, it’s called a “positive surgical margin”. If cancer cells are not found, it’s called a “negative” or “clear margin”.
- Ghani K, Sukumar S, Sammon J, Rogers C, Trinh Q, Menon M. Practice Patterns and Outcomes of Open and Minimally Invasive Partial Nephrectomy Since the Introduction of Robotic Partial Nephrectomy: Results from the Nationwide Inpatient Sample. The Journal of Urology. 2014;191(4):907-913. doi:10.1016/j.juro.2013.10.099.
- Wu Z, Li M, Liu B et al. Robotic versus Open Partial Nephrectomy: A Systematic Review and Meta-Analysis. PLoS ONE. 2014;9(4):e94878. doi:10.1371/journal.pone.0094878.
- Lee S, Oh J, Hong S, Lee S, Byun S. Open Versus Robot-Assisted Partial Nephrectomy: Effect on Clinical Outcome. Journal of Endourology. 2011;25(7):1181-1185. doi:10.1089/end.2010.0670.
- Han K, Song G, You D et al. Comparison of Hand-Assisted Laparoscopic Versus Robot-Assisted Laparoscopic Versus Open Partial Nephrectomy in Patients with T1 Renal Masses. Journal of Endourology. 2014:150127063131006. doi:10.1089/end.2014.0517.
- Vittori G. Open versus robotic-assisted partial nephrectomy: a multicenter comparison study of perioperative results and complications. World J Urol. 2013;32(1):287-293. doi:10.1007/s00345-013-1136-x.
- Zargar H, Allaf M, Bhayani S et al. Trifecta and optimal perioperative outcomes of robotic and laparoscopic partial nephrectomy in surgical treatment of small renal masses: a multi-institutional study. BJU International. 2015;116(3):407-414. doi:10.1111/bju.12933.
- Khalifeh A, Autorino R, Hillyer S et al. Comparative Outcomes and Assessment of Trifecta in 500 Robotic and Laparoscopic Partial Nephrectomy Cases: A Single Surgeon Experience. The Journal of Urology. 2013;189(4):1236-1242. doi:10.1016/j.juro.2012.10.021.
- Pierorazio PM, Patel HD, Feng T, Yohannan J, Hyams ES, Allaf ME. Robotic-assisted versus traditional laparoscopic partial nephrectomy: comparison of outcomes and evaluation of learning curve. Urology. 2011 Oct;78(4):813-9. Epub 2011 Jul 29.
- Kim J, Park Y, Kim Y et al. Perioperative and long-term renal functional outcomes of robotic versus laparoscopic partial nephrectomy: a multicenter matched-pair comparison. World J Urol. 2015;33(10):1579-1584. doi:10.1007/s00345-015-1488-5.
- Wang AJ, Bhayani SB.Robotic partial nephrectomy versus laparoscopic partial nephrectomy for renal cell carcinoma: single-surgeon analysis of >100 consecutive procedures. Urology. 2009 Feb;73(2):306-10. Epub 2008 Nov 26. 2013;32(1):287-293. doi:10.1007/s00345-013-1136-x.
- Kates M, Ball M, Patel H, Gorin M, Pierorazio P, Allaf M. The Financial Impact of Robotic Technology for Partial and Radical Nephrectomy. Journal of Endourology. 2015;29(3):317-322. doi:10.1089/end.2014.0559.
- Choi J, You J, Kim D, Rha K, Lee S. Comparison of Perioperative Outcomes Between Robotic and Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-analysis. European Urology. 2015;67(5):891-901. doi:10.1016/j.eururo.2014.12.028.
- Hillyer S, Autorino R, Laydner H et al. Robotic Versus Laparoscopic Partial Nephrectomy for Bilateral Synchronous Kidney Tumors: Single-institution Comparative Analysis. Urology. 2011;78(4):808-812. doi:10.1016/j.urology.2011.06.012.
- Huang WC, Elkin EB, Levey AS, Jang TL, Russo P; Partial Nephrectomy Versus Radical Nephrectomy in Patients With Small Renal Tumors-Is there a Difference in Mortality and Cardiovascular Outcomes; The Journal of Urology, Vol. 181, 55-62, January 2009.
- Guide for Management of Clinical Stage 1 Renal Mass, 2009; American Urological Association Education and Research, Inc., URL: http://www.auanet.org/education/guidelines/renal-mass.cfm
- Aboumarzouk, O. M. S., R. J.; Eyraud, R.; Haber, G. P.; Chlosta, P. L.; Somani, B. K.; Kaouk, J. H. (2012). Robotic Versus Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis. European Urology.
- Zhang, X., et al. (2013). Comparison of peri-operative outcomes of robot-assisted vs laparoscopic partial nephrectomy: a meta-analysis. BJU International.
- Zhang, X., et al. (2014). Robot-assisted versus laparoscopic partial nephrectomy for localized renal tumors: a meta-analysis. International Journal of Clinical and Experimental Medicine. 7: 4770-4779.
- Hadjipavlou, M., F. Khan, S. Fowler, A. Joyce, F. X. Keeley and S. Sriprasad (2016). "Partial vs radical nephrectomy for T1 renal tumours: an analysis from the British Association of Urological Surgeons Nephrectomy Audit." BJU Int 117(1): 62-71.
- Xia, L., X. Wang, T. Xu and T. J. Guzzo (2016). "Systematic Review and Meta-Analysis of Comparative Studies Reporting Perioperative Outcomes of Robot-Assisted Partial Nephrectomy versus Open Partial Nephrectomy."J Endourol.
PN 1002150 Rev D 01/2017
Important Safety Information
Serious complications may occur in any surgery, including da Vinci® Surgery, up to and including death. Individual surgical results may vary. Patients should talk to their doctor to decide if da Vinci Surgery is right for them. Patients and doctors should review all available information on non-surgical and surgical options in order to make an informed decision. Please also refer to http://www.daVinciSurgery.com/Safety for Important Safety Information.
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