Kidney Cancer

Kidney cancer is a type of cancer that starts in the kidney. Cancer starts when cells in the body begin to grow out of control. 
The kidneys are a pair of bean-shaped organs, each about the size of a fist. They are attached to the upper back wall of the abdomen and protected by the lower rib cage. One kidney is just to the left and the other just to the right of the backbone. 
The kidneys’ main job is to remove excess water, salt, and waste products from blood coming in from the renal arteries. These substances become urine. Urine collects in the center of each kidney in an area called the renal pelvis and then leaves the kidneys through long slender tubes called ureters. The ureters lead to the bladder, where the urine is stored until you urinate.
A tumor, or mass, is an abnormal growth in the body. A kidney mass, or tumor, is an abnormal growth in the kidney. Some kidney masses are benign (not cancerous) and some are malignant (cancerous). One in four kidney masses are benign. Smaller masses are more likely to be benign. Larger masses are more likely to be cancerous. Some tumors may grow slowly while some can be faster growing – or more aggressive. Aggressive tumors may form, grow and spread very quickly.
Most kidney growths (about 40%) are small, localized masses.  Localized means that the tumor has not spread - from where it first started. The main classes of tumors are:
* Renal cell carcinomas (RCC). These are the most common malignant kidney tumors. They are found in main substance of the kidney, where the filtering occurs. RCC may form as a single tumor within a kidney or as two or more tumors in one kidney.
* Benign kidney tumors. About 20% of tumors removed from kidneys are benign. There are about nine named tumors in this class. Some can grow quite large but they are almost always non-cancerous and do not spread to other organs.
* Wilms tumors. Wilms tumors almost always occur in children and are rarely found in adults.

Radical Nephrectomy:

Radical nephrectomy, which involves the complete removal of the kidney, is the mainstay of treatment for cancers, which are large in size (>7 cm in largest dimension) or involve the central area of the kidney. Central tumors may be close to the major blood vessels (renal artery and renal vein) that bring and remove blood from the kidney and may make it impossible to remove the tumor completely by partial nephrectomy while retaining the blood supply to the rest of the kidney. Radical nephrectomy can be done via open surgery or minimally invasive surgical techniques (laparoscopic or robotic). Laparoscopic or robotic radical nephrectomy provides the patient with a similar chance of complete cure after surgery as compared to open surgery while providing him/her all the benefits of minimally invasive surgery including lesser pain, faster recovery and early discharge from the hospital.

Partial Nephrectomy
Patients may be candidates for robotic partial nephrectomy if they have a small kidney tumor or when removing the entire kidney could result in kidney failure and the need for dialysis.  Because of recent medical breakthroughs, robotic partial nephrectomy is the preferred method of surgical intervention for patients with smaller kidney tumors <4 cm in size. However, tumors between 4 and 7 centimeters can be treated with robotic partial nephrectomy if they are located in certain areas. his has significant
advantages as compared to taking out the whole kidney: * It enables the preservation of maximum kidney function 
* It significantly decreases the chances of kidney failure (chronic renal failure) and the future possibility of needing dialysis 
* It decreases the chances of developing secondary medical problems due to decreased kidney function including high blood pressure, heart attacks and brain stroke 
* It has now been proven in research that due to the above factors, patients undergoing partial nephrectomy for small tumors live longer than those who undergo radical nephrectomy.

Robotic Partial Nephrectomy

A robotic partial nephrectomy is performed by making small incisions in the abdomen where the robotic surgical equipment and camera can be inserted. The abdominal cavity is then inflated with carbon dioxide gas to provide space for the manipulation of the surgical equipment and camera to access the cancerous tissues. Under the command of the robotic surgeon, the blood flow to the cancerous kidney is stopped, allowing the kidney to be dissected and the cancerous portion to then be to then be detached from the surrounding tissue. The tumor is removed from the body and the surgeon sews the remaining section of kidney back together.
Robotic Partial Nephrectomy results in a cancer cure rate equal to that of open surgery, but with far less pain and much quicker recovery.
Often, robotic surgery makes minimally invasive surgery possible. The benefits of minimally invasive surgery include: Fewer complications, such as surgical site infection:
*Less pain and blood loss
*Quicker recovery
*Smaller, less noticeable scars
*Shorter Hospital Stay
*Better Cosmetic Results


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