Kidney Cancer Surgery Options
In most cases of kidney cancer, the treatment will include surgery. This procedure may involve the partial or total removal of the affected kidney, even if the cancer is advanced (spread to the other organs) because doctors had been found that surgery can help a patient to live longer, and relieve other symptoms such as pain and bleeding.
Types of Surgery
Based on the stage of the cancer and where is located, a surgeon will perform either partial or a total nephrectomy.
In radical nephrectomy, the entire kidney, along with the adrenal gland and the surrounding fatty tissues are removed. The surgical incision can be in the abdomen, under the ribs or in the back. If the cancerous tumor is extended and affects the main vein of the kidney (called the renal vein) or the vein that empties the heart (known as inferior vena cava), a cardiac surgeon will work with the kidney specialist and will place the patient on cardiopulmonary bypass (a machine that supports that helps the blood circulate while bypassing the heart).
Newer surgical procedures can also be used. Instead of using the classical incision to access the kidneys, a surgeon may use laparoscopy (which involves several small incisions which are used to insert surgical instruments that will help remove the tumor).
The da Vinci system is a robot-assisted laparoscopy and is done remotely. The surgery is controlled by the doctor, but is done by the arms of the robot.
The advantages of laparoscopic surgeries include fewer days in hospital, faster recovery and less pain in the following days after surgery. However, the classical approach may be needed of the tumor is large (over 10 cm) or had been extended to the kidney’s veins or lymphatic system.
If the cancer is in an early stage, and the tumor is smaller, a surgeon may be able to save the kidney, and remove only the affected tissue. This procedure is known as partial nephrectomy. This can be done either laparoscopic (including da Vinci system) or using the classic incision.
If the lymph nodes are affected, they may be removed as well, and this procedure is called regional lymphadenectomy. The surgical removal of the adrenal glands (which are located on top of the kidneys) is known as adrenalectomy, and is usually done along with radical nephrectomy. If the cancerous cells spread to other organs as well (i.e. lung, bones or liver), the surgeon will try to remove these tumors as well.
Book an appointment with your specialist and discuss all the risks and benefits of surgery. Generally speaking the risks associated with any surgery includes symptoms caused by anesthesia and the anesthetic drugs, bleeding in excess, the development of blood clots, pain and infections. In some cases of kidney surgeries, it is possible that other organs (i.e. spleen, the intestines) and blood vessels could be damaged. Excess air may develop in the chest (a condition called pneumothorax). Other complications include kidney failure and hernia (at the site of incision).