Robotic surgery removes big kidney tumor, allowing patient to keep organ

A big tumor has been successfully removed from the left kidney of a patient by robotic surgery and innovative methods at Shanghai's Xinhua Hospital that allowed the organ to be retained.

Usually, tumors over 4 centimeters in diameter involve removal of the entire kidney and it is extremely challenging to only remove the tumor but keep the organ.

The 52-year-old patient, who works in Spain, had a strong desire to keep the kidney and had consulted doctors at both home and abroad. All doctors suggested removal of the kidney.

The man went to Dr Cui Xingang of Xinhua Hospital where doctors said it was a risky surgery because the tumor was big and located close to major blood vessels.

"The tumor was big, almost half the size of the kidney; and its position was deep inside the organ with complicated blood vessels, just like the core of an apple. Any damage to the vessels could cause serious bleeding," Cui said.

"It was also a cystic tumor, like a big blister consisting of many small blisters. We had to treat it like an egg. If it burst, it could cause a spread inside the abdominal cavity."

Cui said advanced technology gave him confidence.

A 3D modeling process before the surgery was able to accurately calculate the distance and relation between the tumor and major blood vessels and how much kidney function could be kept after the operation.

"Removal of the entire kidney is usually the best treatment for cancer. Research in the past 20 years shows that the treatment effects for patients having the entire kidney removed and those keeping the organ is the same. The latter has a better and longer survival," Cui said.

Keeping the kidney is very meaningful, as patients have to undergo a kidney transplant if the sick kidney is removed and the other kidney has problems in the future, according to experts.

"If the tumor can be removed completely, the risk of cancer relapse and spreading is the same. Patients with two kidneys can have a better and safer life in the future. However, it is much more complicated for doctors to keep the patient's kidney than removing it," Cui said.

"The da Vinci robot-assisted surgical system was able to expand the surgery region by 10 to 15 times and improve doctors' stability, accuracy and flexibility. It helped achieve a more accurate and quicker tumor removal and suturing," he said.

The complete surgical operation lasted only 40 minutes, during which the tumor was removed completely. The patient was discharged today with full recovery.