Robot powers new kidney cancer surgery at Vanderbilt-Ingram Cancer Center

S. Duke Herrell, M.D., associate professor of Urologic Surgery at Vanderbilt-Ingram Cancer Center, has performed the first robotic laparoscopic kidney cancer surgery at Vanderbilt University Medical Center.

Bannar Rawlings, 30, was one of the first VUMC patients to undergo the new minimally invasive procedure. Her kidney cancer was detected by Vanderbilt radiologists during an MRI for a second back operation. “After having the back surgeries, I wanted my downtime to be as short as possible and I wanted the pain to be minimal,” Rawlings said. “It sounded like a good thing all around to me. It’s great as long as you have the right doctor and I think Dr. Herrell was the right doctor for the operation.”

Herrell, director of Minimally Invasive Urologic Surgery and Robotics, has performed more than 1,000 laparoscopic kidney surgeries and partial nephrectomies, making him one of the most experienced laparoscopic kidney surgeons in the country.

“Twenty years ago there was one operation if there was something wrong with your kidney and that was to make a big, flank incision in your side, at least six to eight inches, and remove your entire kidney,” Herrell explained. “That was done whether your tumour was the size of a dime or a football. Research has found that the removal of smaller tumours, while leaving the normal portion of the kidney, is safe from a cancer standpoint and helps prevent development of kidney insufficiency.”

Robots, like the DaVinci system, may offer surgeons even more control. Unlike normal laparoscopic tools, the robot has a wrist action which allows the surgeon to manoeuvre needles and sutures more easily and perform more delicate movements.

“Reconstructing kidneys when you’ve taken them apart can be very challenging and you’re doing it in a pressured environment because you have the blood flow to the kidney stopped,” Herrell explained. “With the robot, you control the camera and the robot’s other arms for suturing and retraction. We now have a surgery that’s going to benefit the patient, get rid of the cancer and allow the patient to go home in a few days and recover faster.”

(Source: Vanderbilt-Ingram Cancer Center: January 2009)