Surgery is the most common treatment for kidney cancer, and very often, the only treatment required for tumors that have not moved outside the kidney. As Medicine is an art and there are often many approaches to your care, the UCLA Kidney Cancer Program prioritizes the approach based on the following principles:
There are important surgical decisions such as 1) does the patient need treatment? 2) can the kidney be saved? 3) should we offer a traditional open or minimally-invasive option (laparoscopy or robotics). Based on the above priorities factoring tumor characteristics and patient anatomy/comorbidities, the UCLA Kidney Cancer Program will offer an individualized treatment plan.
Partial-Nephrectomy
Robotic-Partial-NephrectomyA partial nephrectomy is the surgical removal of tumor with sparing the adjacent normal kidney. While once reserved for select situations, in the 1990’s the UCLA Kidney Cancer Program expanded indications by pioneering the concept of the “elective” partial nephrectomy long before it came to be considered the standard of care. Often preservation of kidney function may improve quality and quantity of life.
For large, invasive tumors, often the entire kidney needs to be removed. A radical nephrectomy can be performed in both the open and laparoscopic / robotic manner. While many centers do not perform a lymph node dissection, UCLA Kidney Cancer Program’s surgeons perform lymph node dissections whenever there is high suspicion for lymph node involvement to limit local/regional recurrences by removing any potential sites of disease.
Open surgery is performed by making an incision in the patient's side, abdomen or lower back to approach the kidney. The surgical team uses their hands to perform the procedure. Laparoscopy is a minimally invasive surgical procedure, where the surgeon inserts instruments and a camera through keyhole incisions to perform the operation. This can be performed with traditional or robotic-controlled instrument (Da Vinci Robot). When needed over traditional laparoscopy, the robotic approach may provide very precise movements and the 3D camera offers an improved visual field. At UCLA the majority of operations are performed via a minimally invasive approach, however the team is adept at all surgical options to provide our patients the best outcome.
