Robotic surgery performed to remove 20 cm mass from kidney

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 20 cm cancerous mass removed from 63-year-old man’s kidney; doctors save kidney through robot-assisted partial nephrectomy surgery

In a rare-of-its-kind surgery, doctors at Max Hospital Shalimar Bagh, performed a robot-assisted partial nephrectomy to remove a large mass of size around 20 cm, from his right kidney, which was identified as a renal cell carcinoma (kidney cancer). The delicate procedure performed, had not only saved his life but also his kidney, pertaining to his old age and other co-morbidities.

63-year-old Mr. Raj Singh Suhag, was a pre-existing heart patient, having coronary artery disease (CAD) post stenting with an ejection fraction of only 30%. The patient was also diabetic and had hyperthyroidism with thyrotoxicosis. The patient visited Max Hospital Shalimar Bagh in a critical condition with decreased appetite, nausea, and vomiting for over one month.

“Detailed investigations revealed a large right renal mass of size 18 X 14.3 X 19.7 cm, arising from the upper pole, which was then confirmed through PET CT scan. While the DTPA scan showed a good left-functioning kidney, the right kidney function was mildly impaired. Pertaining to the co-morbidities and associated complications, the team decided to save the right kidney and successfully performed a robot-assisted partial nephrectomy. The postoperative period was uneventful and the patient was discharged from the hospital after 3 days of surgery. Final histopathology report revealed papillary renal cell carcinoma. After 3 months of follow-up, at the present patient is doing well.” Said Dr. Surender Dabas, Senior Director & HOD- Surgical Oncology Max Hospital Shalimar Bagh, New Delhi.

Renal cell carcinoma (RCR) or Kidney cancer is one of the aggressive cancers constituting a malignancy of 2-3% of all cancers; hence, awareness is very low among the general population. Robot-assisted surgeries are currently revolutionizing the way surgeries are conducted across the globe. Such surgeries involve minimal blood loss, quick recovery, shorter hospital stays, and a faster return to normal life.

“With the increased availability of advanced radiology services, the majority of such tumors/cancers are now diagnosed at an early stage. These have very high cure rates following timely surgery, which not only saves the kidney, eliminates the chances for transplantation, but also improves the quality of life. Present-day surgical techniques involving the latest state-of-the-art surgical robot, the surgeons can successfully remove even the most complex tumors/ cancerous mass along with saving most of the normal kidneys using minimally invasive surgical techniques (Robot-Assisted Partial Nephrectomy). The patient resumes diet and movement the very next morning and can be discharged from the hospital on day 2 after surgery.” Added Dr. Dabas

In the last few years, there have been many advances in renal replacement and organ support. Robot-Assisted partial nephrectomy has become extremely useful as it results in quicker recovery, less pain, and smaller scar with quicker healing. Unlike regular open surgeries for kidney transplantation where the patient receives the kidney through a more extensive muscle cutting process, robotic surgery is conducted with only a small incision and involves no cutting of muscle, where the kidney function is intact. Blood loss during surgery and the scope for human error are also minimized.

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