Robotic Partial Nephrectomy

A robotic partial nephrectomy is a 3-4 hour robotic surgical procedure during which a patient with a kidney tumor is able to have the diseased portion of their kidney removed. Patients that undergo a partial nephrectomy don’t have their entire kidney removed as the name implies; they are able to keep the healthy part of their kidney and continue using it throughout their lifetime. This procedure is highly distinguishable from a laparoscopic partial nephrectomy, which involves making small (~1cm) incisions into the abdominal area to be able to observe the kidney with laparoscopy equipment and filling the abdomen with gas to create more space for manipulation of the kidney throughout the procedure. The robotic method of partial nephrectomy is much more modernized, using robotic machinery specifically made to be of assistance in surgery and controlled by a surgeon trained to use said machinery. 

Surgeons commonly use a variety of different robotic instruments compiled into one operating system that allow them to complete this removal accurately and precisely. A robotic lens, created similarly to a laparoscopy lens allowing for observation during laparoscopic surgeries, allows for creation of a high definition, fully dimensional image of the person’s anatomy throughout the procedure. They use this projection to find the diseased kidney and utilize other tools to plan the cut they’re going to make in extreme detail. The robotic aspect allows for determination of a specified angle of incision and length of incision. As this planning is done, an ultrasound probe allows for proper analysis of the kidney. To prevent excessive blood loss and stop the kidneys from flooding with blood as the surgeon works, a clamping tool puts pressure on the junction connecting the renal arteries to the kidneys.

Surgeons plan to cut a little past the diseased portion into a small bit of the healthy kidney in attempts to make sure that none of the unhealthy portion of the person’s kidney is left behind after they’re done operating. As they cut, they remove the tumor, fat surrounding the tumor, and anything else they deem to be threatening. Something very commonly removed in addition to the tumor and fat are renal lymph nodes. Renal lymph nodes are filters for fluids, wastes, and immune cells that help the kidney fight infection by draining bad things into the larger lymph nodes. They remove them during nephrectomies to reduce the recurrence of cancer, the primary reason people have nephrectomies of any kind, and improve survival of patients with renal cell carcinoma (RCC; high-risk kidney cancer). The surgery is concluded with the kidney being sutured back together and the diseased portion of the kidney & all other things collected being placed into a small plastic bag.

Written by Kamila Dessus at Incisionary

References

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Laparoscopic and Robotic Partial Nephrectomy» Department of Urology» College of Medicine» University of Florida. (n.d.). University of Florida College of Medicine: Department of Urology. https://urology.ufl.edu/patient-care/robotic-laparoscopic-urologic-surgery/procedures/laparoscopic-and-robotic-partial-nephrectomy/ 

Palapattu, G. S., Kim, H. L., & Belldegrun, A. S. (2025). Lymph Node Dissection in Patients with Kidney Cancer: When Is It Indicated? Reviews in Urology, 5(3), 196. https://pmc.ncbi.nlm.nih.gov/articles/PMC1473016/ 

Partial Nephrectomy: Purpose, Types, Procedure & Recovery. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/16214-open-partial-nephrectomy 

Russell, P. S., Hong, J., Windsor, J. A., Itkin, M., & Phillips, A. R. J. (2019). Renal Lymphatics: Anatomy, Physiology, and Clinical Implications. Frontiers in Physiology, 10. https://doi.org/10.3389/fphys.2019.00251 

Samaritan Health Services. (2016). da Vinci® Surgery - How It Works [YouTube Video]. In YouTube. https://www.youtube.com/watch?v=QksAVT0YMEo