20 CM Cancerous Mass Removed From Kidney With Robotic Surgery

In a rare kind of surgery, doctors at Max Super Speciality Hospital, Shalimar Bagh, performed a Robot-assisted Partial Nephrectomy to remove a large mass of around 20 cm from the patient's right kidney. The mass was identified as a Renal Cell Carcinoma (Kidney Cancer). The delicate procedure saved not only his life but also his kidney considering his old age and other co-morbidities.

The 63-year-old had Coronary Artery Disease (CAD) post stenting, with an ejection fraction of only 30%. The patient also had Diabetes and 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 18 x 14.3 x 19.7 cm, arising from the upper pole, which was then confirmed through a PET-CT scan. While the DTPA scan showed an excellent functioning kidney, the right kidney function was mildly impaired. The team decided to save the right kidney and informed the patient & his family about the co-morbidities & associated complications and successfully performed a Robot-assisted Partial Nephrectomy.

The post-operative period was uneventful and the patient was discharged three days post-surgery. “The final histopathology report revealed Papillary Renal Cell Carcinoma. After three months of follow-up, he is doing well," said Dr. Surender Dabas, Senior Director & HODSurgical Oncology, Max Hospital, Shalimar Bagh. 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 everyday life.

There have been many advancements in renal replacement and organ support in the last few years. Robot-assisted Partial Nephrectomy has become extremely useful as it results in quicker recovery, less pain, and smaller scar with faster 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 the muscle, wherein the kidney function is intact. Blood loss during the surgery and the scope for human error is also minimized.

"With the increased availability of advanced radiology services, such tumours/cancers are now diagnosed at an early stage. These have a very high cure rate following timely surgery, which saves the kidney, eliminates the chances for transplantation and improves the quality of life. With the recent surgical technological advancements involving the latest state-of-the-art surgical robot, the surgeons can now successfully remove even the most complex tumours / cancerous mass and save most of the normal kidneys using minimally invasive surgical techniques (Robot-assisted Partial Nephrectomy). The patient can resume their diet and movement from the next morning and can be discharged from the hospital on day two after the surgery", Dr Dabas added.