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Cutting Edge

Title
Surgeons give the green light in kidney cancer surgery - Archived
Date
04/16/2012
Article

CAMC recently took robot-assisted surgery to a higher level when it purchased a new model that gives surgeons a better view of their procedures.Doctors practicing at CAMC have used a da Vinci robot since 2006 for a variety of procedures. It provides surgeons with improved precision, dexterity and control, which leads to reduced pain, reduced blood loss and a shorter recovery time for patients.

CAMC recently took robot-assisted surgery to a higher level when it purchased a new model that gives surgeons a better view of their procedures.

The Near-Infrared Fluorescence Guidance for the da Vinci Surgical System uses technology similar to a black light so surgeons can better identify kidney tumors, blood vessels and whether the kidney is functioning after a tumor is removed.

“It’s very comforting to know that you’re getting all the cancer,” said Samuel Deem, DO, specializing in urologic oncology. “The most difficult part of a kidney-sparing procedure is getting the entire tumor out while sparing as much kidney as possible.”

First the anesthesiologist injects a green dye into the patient. It takes about one minute for the dye to make it to the kidney. Using the fluorescent light, the surgeon watches the arteries carrying blood to the kidney turn green, then clamps them to reduce bleeding during the procedure.

The dye turns the kidney green, but the tumor remains black.

“We have had excellent results using only the robot,” Deem said. “But with fluorescence imaging, we feel more comfortable taking on the most challenging tumors because we can actually see that we’re not leaving tumor as we remove the mass.”

Deem flips on the fluorescent light at times during the procedure to make sure he’s cutting in the right spot. Then after cutting the tumor away from the kidney, he uses the light to confirm the cancer has been removed.

“We will see green on the edge of the tumor, indicating we haven’t cut into the tumor leaving any behind,” Deem explained. “Green on both sides confirms we took only a small portion of the kidney and have removed the entire tumor.”

“With the da Vinci robot, we have a 3-dimensional, high-definition, magnified image with incredible vision. The fluorescence guidance takes this vision to a new level allowing us to spare nearly all healthy kidney tissue. So with one flip of the switch, we feel much better telling the patient, ‘we have removed the entire mass and you still have more than 90 percent of your kidney.’”

Patients can feel confident knowing this technology means less risk of having to undergo a second surgery and they still have a large functioning kidney. For some people, that can be critical if they have other medical issues such as diabetes or high blood pressure.

“With this new technology, nearly every kidney can be saved and only the tumor removed,” Deem said.

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