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Robotic Urological Surgery

Myths and Fears about robotic surgery

When patients are told they have robotic surgery for urological problems, some are afraid of machines. Others mistakenly think that nothing can go wrong. Some belief, perhaps based on looking at some other videos on social media or from another source and finding out that the robot will make moves on its own, outside the surgeon’s direct control.

“Even if the robot is a great tool, it is the surgeon’s experience to perform a successful surgery.”

Why use a robot for surgery?

The renal cell carcinoma (RCC) incidence has increased in the last two decades but up to 70% of these are small and localized tumours. For most of these tumours, open or laparoscopic radical nephrectomy has proven to be an overtreatment also causing a significant risk factor for the development of chronic renal insufficiency with its specific morbidity including hip fractures and cardiovascular problems.

In the contemporary practice open partial nephrectomy (OPN) is the gold standard for a single small renal tumour but in the last decade, many minimally invasive alternative treatments have been presented.

In particular, laparoscopy has shown benefits over OPN like reduced postoperative pain or morbidity, improved cosmesis, shorter recovery, and length of stay in the hospital, and earlier return to work, but with equivalent efficacy in terms of functional and oncological outcomes. Moreover, in the past years, laparoscopy has gained popularity and laparoscopic partial nephrectomy (LPN) is nowadays considered as one of the standard treatments for renal cancer.

The recent introduction of robotic surgery to urology and, later on, its application to renal surgery with the robot-assisted partial nephrectomy (RAPN) has given us another option for minimally invasive nephron-sparing surgery.

“The first and most common robotic procedure for urologists is prostate cancer.”

Benefits of robotic surgery for kidney

  • Robotic/laparoscopy surgery has several advantages over traditional open surgery, Most Commonly – Smell Incisions.
  • The fastest recovery time and the ability to save more normal tissue when removing a tumour.
  • Using robotic-surgery to treat kidney cancer means one can be more specific during surgery, leading to better safety.
  • This reduces the risk of leaving any part of the back tumour and increases the amount of healthy kidney tissue that can leave in place for patients who are undergoing partial nephrectomy.
  • Like any surgery, time is always a factor when we remove kidney tumours.
  • During a partial nephrectomy, the kidneys have no blood flow during the procedure, for a short duration, due to which may develop chronic kidney disease.
  • Compared to total kidney clearance, this risk is low for patients who only get a part of the kidney removed of “partial nephrectomy“. Robotic surgery helps us work faster than conventional surgery to reduce this risk.
  • Even when the tumour is completely inside the kidneys, before the advent of robotic surgery, doctors must remove the entire kidney through the procedure of radical nephrectomy. Now we can use robotic surgery to remove only part of the kidneys through the process of “partial nephrectomy

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