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A potentially life-threatening kidney condition normally treated with open surgery is now being handled with less-invasive robotic surgery at Edward Hospital.
According to Ranko Miocinovic, M.D., a urologist with DuPage Medical Group, only nine academic medical centers in the country have published that they have robotically performed a radical nephrectomy with vena cava tumor thrombectomy, involving a total of 33 patients.
On May 3, 2016, Dr. Miocinovic did the first of these surgeries at Edward. The patient was a 57-year-old woman who had gone to the Edward ER about a week earlier with extreme pain in her side and blood in her urine.
Scans showed it wasn't a kidney stone causing these symptoms as suspected, but a large mass on her kidney. She also had a thrombus (clot) in her vena cava. Using the da Vinci Surgical System, Dr. Miocinovic was able to perform the surgery through an incision of about three inches.
In about 10 percent of advanced kidney cancer cases, a clot of cancer tissue travels to the veins of the kidney and blocks the organ’s main vein, the inferior vena cava. This is a potentially life-threatening complication if the clot makes its way to the heart or lungs.
Traditionally, the primary treatment would be an open surgery called radical nephrectomy with vena cava tumor thrombectomy, which involves taking out the kidney and removing the clot.
Removal of the clot is typically the more complex and challenging part of the procedure. It requires separating the kidney from the surrounding organs for better access, opening the vein, removing the tumor and then reconstructing the vein while carefully using clamps to avoid blood leakage.
With da Vinci, patients have a less invasive option for this highly complex procedure. The system is one of the most advanced surgical technologies available, and physicians who use it have special training and appropriate expertise with the technology. The da Vinci system allows the physician to insert miniature instruments and a tiny high-definition 3D camera through small incisions.
"The system's enhanced magnification helps us see the small vessels on our monitor, and the flexible robotic "wrists" give us greater precision as we operate them from the control panel," says Dr. Miocinovic.
"Smaller incisions mean less loss of blood and overall fluids,” he says. “There's a reduction in inflammation and scarring, and typically a shorter recovery. This patient would not have survived without surgery. She was home two days after the surgery with her chance of being disease-free in five years dramatically improved."
Learn more about Edward-Elmhurst Health’s robotic surgical procedures.
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