The robotic surgical platform can be applied to allow for partial removal of the kidney for localised kidney cancers. These cancers are detected on ultrasound, CT or MRI scans and tend to be < 5cm in diameter. The cancers need to be in a certain anatomic position to allow for safe robotic partial nephrectomy.
Robotic partial nephrectomy is performed through several key hole incisions and once the kidney is mobilised, the vessels are clamped, such that the tumour can be meticulously excised, along with a rim of normal tissue, in order to achieve surgical clearance at the margins and the defect is subsequently sewn up in several layers.
The typical admission time is 3 days in hospital and the keyhole robotic approach therefore removes the need for the traditional long and potentially morbid and painful flank incision.
Certain central hilar tumours are best not attempted using the robotic approach and Dr Haddad in these scenarios, performs the traditional open partial nephrectomy operation. Dr Haddad’s robotic fellowship and high volume exposure has allowed him to offer this operation with excellent cancer clearance and other operative outcomes.
In particular, the renorrhaphy renal bed suturing is far superior robotically over pure laparoscopic suturing. This may mean that early post operative bleeding and urine leak is less likely using the robot.
The robotic magnification and dissection ability of the Endowrist instruments improves dissection and possible clearance capabilities.