Kidney Disorders Treated With Robotic Surgery

Sharp HealthCare is using the da Vinci® Robotic Surgical System to treat various kidney disorders including bladder cancer, kidney cancer and kidney stones. With robotic kidney surgery, patients experience less scarring and shorter recovery times compared to traditional surgery.

Kidney Disorders
The kidneys are two small fist-sized organs located behind the abdomen on each side of the spine above your waist. By producing urine, kidneys remove toxic by-products and excess fluids from the body to help maintain a critical balance of fluid, salt, potassium and acid. The following kidney disorders can be treated with da Vinci® robotic surgery at Sharp HealthCare.

Bladder Surgery - Cystectomy
The bladder is a hollow organ that stores urine. It is located inside the lower abdomen, is about the size of a grapefruit and is distensible (elastic), which allows its muscular wall to get larger and smaller. Bladder cancer is a disease in which cancer cells form in the tissues of the bladder. More than 67,000 new cases of bladder cancer are diagnosed in the United States each year, according to the National Cancer Institute. It is the fourth most common cancer among men and ninth most common among women in the U.S. Fortunately, most people with bladder cancer will survive the disease if treated in time.

Treatment options depend on the stage and grade of bladder cancer. Standard treatment options for bladder cancer include surgery, radiation and chemotherapy.

Depending on the patient's type, stage and grade of bladder cancer, several treatments may be used in combination to increase the chances of a cure. Surgery or resection is the primary bladder cancer treatment and is performed in more than 90 percent of bladder cancers (either alone or in combination with another therapy). When cancer has spread to the muscle wall of the bladder, a radical cystectomy is recommended.

A cystectomy is the removal of all or part of the bladder and possibly the removal of nearby lymph nodes and organs that may contain cancer. If the bladder is removed, the surgeon creates a new way or path for urine to be stored and/or to leave the body.

Cystectomy is traditionally performed using an open approach, meaning the surgeon must make a large abdominal incision to access the bladder. Another approach, conventional laparoscopy, is less invasive but limits the doctor's dexterity compared to open surgery.

If your doctor recommends surgery for bladder cancer, you may be a candidate for da Vinci Cystectomy. Da Vinci uses state-of-the-art technology to help your doctor perform a more precise operation than conventional surgery allows. It offers several potential benefits over traditional open surgery. The precision and dexterity of the da Vinci surgical system's advanced instrumentation allows for a minimally invasive approach to treating bladder cancer.

Blockage of the Ureter
Some people are born with a rare condition known as ureteropelvic junction (UPJ) obstruction, in which the flow of urine is blocked at the juncture between the kidney and the ureter, the tube that carries urine to the bladder. Although less common in adults, UPJ obstruction can occur as a result of kidney stones, previous surgery or disorders that can cause inflammation of the upper urinary tract. Blockages of the ureter can create serious side effects like infections and kidney stones. If left untreated, blockages can cause chronic pain and may damage the kidney over time.

UPJ obstruction can be surgically treated by performing an operation called a pyeloplasty to repair the blockage. With da Vinci robotic surgery, pyeloplasty can be performed by making small incisions in the abdomen, resulting in less pain, less scarring, a shorter hospital stay and quicker recovery as compared to traditional open surgery.

Kidney Cancer
Kidney cancer can form in the small tubes inside the kidney. Those tubes - located in the center of the kidney where urine collects - are used to filter blood of the wastes produced by the body. According to the American Cancer Society, kidney cancer is diagnosed in about 54,000 Americans each year, and more than 13,000 do not survive the disease. Kidney cancer is slightly more common in men and is usually diagnosed between the ages of 50 and 70 years. With early diagnosis and treatment, kidney cancer can be cured. If found early, the survival rate for patients with kidney cancer ranges from 79 to 100 percent.

Kidney cancer is fairly resistant to radiation and chemotherapy. As a result, the gold standard treatment for localized kidney cancer is a nephrectomy, or removal of the kidney or kidney tumor.

A nephrectomy can be performed as a radical, simple or partial. The kidney, the adrenal gland, nearby lymph nodes and other surrounding tissue are removed in a radical nephrectomy. Simple nephrectomy is the removal of just the affected kidney. Partial nephrectomy removes the tumor from the kidney and spares the rest of the normal kidney.

Kidney Stone Surgery
A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine and often severe pain in the abdomen, flank or groin. One in every 20 people develops a kidney stone at some point in their life.

Most kidney stones eventually pass through the urinary tract on their own within 48 hours, with ample fluid intake. Pain medications are used for symptom relief. When over-the-counter medications are not sufficient for pain control, narcotics may be prescribed. For kidney stones that do not pass on their own, a procedure called lithotripsy is often used. In this procedure shock wave, laser or ultrasound energy is used to break up a large stone into smaller pieces that can then pass through the urinary system.

Kidney Surgery
Kidney surgery is traditionally performed using an open approach, meaning doctors must make a large incision in the abdomen. Today, the more common approach is conventional laparoscopy. This involves removal of part or the entire kidney through small incisions (5 to 12 millimeters). It is less invasive and usually results in less blood loss, postoperative pain and a quicker return to normal activity.

If your doctor recommends surgery for kidney cancer, you may be a candidate for da Vinci robotic surgery. This state-of-the-art robotic surgery uses state-of-the-art technology to help your doctor perform a more precise, minimally invasive operation than conventional surgery. Da Vinci robotic surgery is especially useful for partial nephrectomies where the remaining kidney needs to be repaired and reconstructed after the cancer is removed.

Pyelolithotomy
Surgical techniques have also been developed to remove kidney stones when other treatment methods are not effective. This may be done through a small incision in the skin (percutaneous nephrolithotomy) or through an instrument known as an ureteroscope, which is passed through the urethra and bladder up into the ureter. If these less invasive procedures are unsuccessful, a procedure called pyelolithotomy can be performed. For this procedure, the collection portion of the kidney is opened, the stone is removed and the kidney is repaired.

Pyelolithotomy is available to patients at Sharp, using the da Vinci Robotic Surgical System. If your doctor suggests surgery, you may be a candidate for da Vinci pyelolithotomy. Da Vinci uses state-of-the-art technology to help your doctor perform a more precise and less invasive operation than conventional open surgery allows. It offers several potential benefits over traditional open surgery. The precision and dexterity of the da Vinci surgical system's advanced instrumentation allows for a minimally invasive approach to treating urinary stones.

For More Information
To learn more about Sharp's robotic surgery services or to find a Sharp-affiliated physician, search for a San Diego urologist or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm.