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Surgery / Urologic Surgery: Laparoscopic Radical and Partial Nephrectomy

Laparoscopic Radical Nephrectomy (removal of the entire kidney)

Laparoscopic cancer surgery has become accepted as a minimally invasive option for a majority of renal cancer surgery.

Laparoscopic radical nephrectomy involves removal of the kidney through 4 small openings about a ½ inch in diameter. The entire kidney is put into a special bag within the abdominal cavity. Then the mouth of the bag is brought out through one of these small openings. The kidney is broken up into small pieces in this impermeable sack and the pieces are all removed. For some types of kidney cancer, the kidney is removed without breaking it up by enlarging the one of the incisions to 3 inches.

The picture on the left shows the scars made from four amall incisions.

With either approach, the patient recovery is much quicker than the traditional open surgery. The requirement for pain killing medications is also much less and the patient returns to normal activities within a short period of time.

This picture on the left shows the length of the incision required for traditional, open-surgical removal of the kidney.

Cure rates for the laparoscopic approach over the last ten years has been similar to the open surgery for kidney cancer. The surgeons in this department have the largest experience with this technique, since Washington University School of Medicine is where it was first developed and applied.

Laparoscopic Partial Nephrectomy

Several types of renal cancer that can be detected those which are less than 2 inches in size. These tumors, when in certain locations of the kidney, can be treated by removal of the tumor and the surrounding kidney tissue (i.e. partial nephrectomy) rather than removing the entire kidney.

Partial nephrectomies have shown to be as effective as removal of the entire kidney in selected patients with small tumors.

Partial nephrectomies can now be performed via the laparoscopic approach in a safe and effective manner. In many such patients a hand assisted approach is utilitzed.

Hand-assisted laparoscopy involves the surgeon inserting one hand through a special device that requires an incision that is 3 inches long.

A variety of modern methods are being used to control bleeding as well as urine leakage from the cut surface of the kidney. This includes fibrin glue, collagen, the argon beam coagulator, bipolar coagulation, and lasers.

The world's first studies on laparoscopic nephrectomy were done at Washington University by Ralph Clayman, MD and one of his former fellows Howard Winfield, MD

Regional/National Referrals

We treat many patients from outside the region and outside United States. For North American referrals, physicians may call the Barnes-Jewish Hospital Doctors Access Line at (800) 252-DOCS (3627).

Patients in the continental United States may refer to Family and Guest Services for assistance with lodging.

International Referrals

Physicians and patients from countries outside of the United States may view a complete list of our Centers of Excellence available for International Healthcare Referrals or physicians may contact us by email, with a short summary of the patient's diagnosis and your initial treatment plan. We will forward this summary to the right department for review and follow-up. Although English is preferred, you may email in your own language.

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Copyright 2015 Washington University School of Medicine
Copyright 2015 Washington University School of Medicine