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Keyhole Laparoscopic Kidney Cancer Surgery

  • Radical (complete) and partial kidney removal with keyhole surgical techniques
  • Advantages of less pain, improved cosmesis, earlier recovery and return to normal activities

Surgical Removal Of The Kidney Cancer is the Gold Standard Curative Approach.

This is often achieved with keyhole / laparoscopic minimally invasive techniques unless the tumour is very large or locally advanced and involves adjacent organs or major veins. The operations include radical or partial nephrectomy.

In most cases NO further adjunctive treatment such as chemotherapy or radiotherapy will be required after surgery.

Laparoscopic Radical Nephrectomy:

This is keyhole surgery to remove the entire kidney for a cancerous growth and involves the removal of one kidney together with the adjacent tissues around the kidney usually including fat, lymph nodes and often the adrenal gland. The aim of the operation is to completely remove the kidney and the surrounding tissue.

Traditionally this operation is performed through a large incision either at the front of the abdomen or alternatively at the side of the rib cage. Whilst this approach provides good access to the kidney it is associated with greater post operative pain, slower recovery and a prolonged convalescence period with higher wound complication rate.

Laparoscopic nephrectomy, in contrast to open is performed through small incisions in the skin and small tubes called ports are then placed into the abdominal wall allowing access to the kidney. Specialised instruments including telescopic cameras are then used to allow improved, magnified vision and precise surgery. Tumours up to 10-12cm can often be treated laparoscopically although this does depend on the actual position of the tumour and if there is any evidence of local extension of the cancer.

The operation is performed under general anaesthesia and most patients spend 2 nights in hospital before returning home with usual resumption of normal activities within 4-6 weeks.

Laparoscopic Partial Nephrectomy:

If you need surgery for an abnormal presumed cancerous growth in the kidney, your entire kidney may not need to be removed. Depending on location and size of the growth, you may be able to undergo surgery to remove the growth itself surrounded by a small rim of normal kidney tissue whilst preserving as much normal healthy kidney tissue as possible. This surgery is called a partial nephrectomy or kidney (nephron) sparing surgery.

Why Have a Partial Nephrectomy?

Studies have shown that when patients have their whole kidney removed they are more likely to develop chronic kidney disease after surgery compared to patients who have a partial nephrectomy. Kidneys play a major role in maintaining good health, in essence they are the body’s filter, and those with chronic kidney disease may need dialysis (or help with external filtration) to remove waste and excess water from the blood in the years to come especially if the remaining kidney becomes diseased.

Who is suitable for a laparoscopic partial nephrectomy?

This is technically a much more challenging operation than a complete laparoscopic nephrectomy and not all patients will be suitable for this approach. A laparoscopic partial nephrectomy is suitable for those individuals with a small renal lesion which is in a favourable position that can be readily accessed. A radical nephrectomy is the standard approach for renal tumours which are larger or centrally placed within the kidney.

The added potential risks of having a laparoscopic partial nephrectomy include bleeding, urine leaks, incomplete cancer removal and conversion to open surgery. You should discuss your individual risk based on your clinical scenario with Dr Louie-Johnsun when considering these treatment options.