New Technology Means Kidney Cancer can be Treated Laparoscopically
By Alexa Pozniak
Beth Israel Deaconess Medical Center correspondent
In late November of last year, Charlie Fischer was driving home from a high school basketball game he had officiated when he started to suffer from a sudden onset of severe, stabbing pain in his back.
At 65 years old, Fischer was in relatively good health, but the pain was so persistent that it led him straight to a local hospital. The diagnosis was a kidney stone, confirmed by a CAT scan. Two days later, Fischer's doctor called with some shocking news - the scan had also detected a mass in his left kidney. An MRI confirmed it was probably cancer.
"I was surprised but not shocked," said Fischer. "My dad had cancer so in my mind it was not if, but when for me. I knew my chances were pretty good."
Local doctors determined that the best course of treatment would be to remove the entire kidney. Wary of the major surgery, Fischer and his son Chris, an emergency room physician at
Beth Israel Deaconess Medical Center, decided to get a second opinion.
Dr. Andrew Wagner, Director of Minimally Invasive Urologic Surgery at BIDMC, determined that the tumor was in a tough spot, but felt confident he could remove it via laparoscopic surgery, something he and his team have been performing for five years, and save the rest of the kidney.
"Few other centers in the country are doing more advanced kidney surgery than we are," explains Wagner.
As recently as five to 10 years ago, surgery to treat kidney cancer required long incisions and lengthy hospital stays. But thanks to exciting advances in laparoscopic and robotic technology, most tumors can now be approached through minimally invasive surgery. The benefits are impressive, cutting down on post-op pain, risk of infection, and recovery time. But the procedure has yet to become mainstream. BIDMC, however, remains on the leading edge of care.
"If you look at kidney surgery at hospitals across the country - only about 20-30 percent are being done minimally invasive and many patients are undergoing removal of the entire kidney when they would be better served by a partial nephrectomy," said Wagner. "Over 90 percent of our patients are able to undergo minimally invasive kidney surgery, whether it be for small or very large tumors."
If a tumor is detected and the cancer has not spread, a partial nephrectomy, during which only some of the organ is removed, can often be performed. Four half-inch incisions are made, instead of the traditional 8- to 12-inch incisions. Dr. Wagner uses robotic assistance to carefully remove the tumor laparoscopically while preserving the remaining kidney. In many cases where the tumor is very large, the entire kidney can be removed this way as well.
Charlie Fischer was pleased after undergoing a partial nephrectomy.
"I had the surgery on a Monday, went home from the hospital on Wednesday, and by the end of the week I was back to normal," Fischer said. "I hope everyone has the same experience. I'm a walking endorsement."
Above content provided by Beth Israel Deaconess Medical Center.
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Posted July 2011