America
Indian American surgeon masters robotic surgery for advanced kidney cancer
New York, July 31
In pioneering work, a team
led by an Indian American surgeon has successfully performed robotic
surgeries in advanced kidney cancer patients.
The team from USC
Institute of Urology in Los Angeles performed the lengthy procedure
using only seven small incisions and four robotic tools.
Surgery
is required when cancer of the kidney causes a level III thrombi or clot
that develops in the major vein leading back to the heart.
Generally,
this complicated procedure - called inferior vena cava (IVC)
thrombectomy - is performed using a large open incision primarily
because the vein is often difficult to reach.
“This complicated
procedure for renal cancer is one of the most challenging open urologic
oncologic surgeries,†explained Inderbir S. Gill from the USC Institute
of Urology, part of Keck Medicine of USC in Los Angeles.
While
this complication occurs in only four-10 percent of all patients with
otherwise organ-confined kidney cancer, surgery is the only cure.
“The ability to do this complicated procedure in a minimally invasive way represents a major advancement,†Dr Gill noted.
So
far, the team has performed the robotic surgery on nine patients with
renal cancer and Level III thrombi treated with robotic IVC
thrombectomy.
After about seven months of follow-up, all have survived and eight show no evidence of disease.
One patient had a spinal tumor and has since undergone further surgery.
Because
the surgery involves removal of the thrombus as well as removal of the
diseased kidney, the surgeon must remove the clot first to prevent it
from breaking off and causing a potentially fatal embolism.
“All
necessary surgical maneuvers could be performed completely robotically
without open conversion or mortality,†Dr Gill commented.
“Although
our experience is yet initial, we believe that robotic IVC thrombus
surgery has considerable potential for the future," he added in a paper
published in the Journal of Urology.