Advanced Surgical Methods Offer Kidney Cancer Patients Faster Recovery

Each year more than 28,000 Americans are diagnosed with kidney cancer. The kidneys are two bean-shaped organs that are located in the back, under the rib cage. Their main function is to filter waste from the blood. Men and women are equally affected by kidney cancer, with those over 40 at greater risk.

Until recently, the most common treatment for kidney cancer was a nephrectomy, the surgical removal of the kidney. Nephrectomy is a major operation, involving a 12 – 18 inch incision in the patient’s abdomen or flank and usually the removal of a portion of one or two ribs to expose the kidney. It requires a lengthy recovery period.

Surgical innovations have now given kidney cancer patients a less invasive option to nephrectomy. For the last few years, doctors at Northwestern Memorial Hospital have been offering laparoscopic surgery to their kidney cancer patients as an alternative to nephrectomy. Using only three small incisions (each about an inch long), the surgeon inserts a laparoscope, a small, tube-like instrument with a camera, into one of the incisions. The camera allows him to guide tiny surgical instruments, which are inserted into the other incisions, by projecting the image onto a monitor. Towards the end of the operation, the doctor enlarges one of the incisions to about 3 inches, through which he removes the kidney. Although the operation can last a bit longer than traditional surgery, there are fewer complications and recovery times are substantially shorter than with nephrectomy.

Comparing a patient’s recovery from nephrectomy, Dr. Robert B. Nadler, Director of Endourology, Laparoscopy and Stone Disease at Northwestern says, “There’s no comparision. With laparoscopy, the patient is resuming normal activities within two weeks, whereas with traditional surgery, they may not feel like themselves again for several months.” And the hospital stay is only two to three days for laparoscopy, compared to five to 10 for a nephrectomy.

Many patients are finding out about laparoscopy from friends or relatives who have already had the surgery. Or they read about it on the Internet. “Laparoscopy has taken off because surgeons are realizing it is just as effective as open surgery at treating the cancer and patients are demanding it,” says Dr. Nadler. Except for extremely large tumors that have invaded adjacent organs, he says that nearly all kidney tumors can be treated laparoscopically.

With their success treating kidney cancer patients with laparoscopic surgery, doctors at Northwestern Memorial Hospital have become leaders in finding minimally invasive ways to treat the disease. Currently, Northwestern is one of only three hospitals in the country performing laparoscopic renal cryosurgery, a new technique that allows surgeons to freeze small tumors using liquid nitrogen. This procedure requires only three small incisions for the laparoscope and surgical instruments. The larger incision to remove the kidney is unnecessary because the kidney is not removed from the patient. This novel technique has been producing very promising results and doctors at Northwestern expect laparoscopic renal cryosurgery to become another popular alternative to nephrectomy for some patients.