Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New technique for minimally invasive robotic kidney cancer surgery

14.12.2012
Urologists at Henry Ford Hospital have developed a new technique that could make minimally invasive robotic partial nephrectomy procedures the norm, rather than the exception for kidney cancer patients. The technique spares the kidney, eliminates long hospital stays and provides better outcomes by giving the surgeon more time to perform the procedure.

Dubbed ICE for Intracorporeal Cooling and Extraction, the technique may allow more kidney cancer patients to avoid conventional open surgery – now used in the vast majority of cases – and its possible complications, including infection, blood loss, and extended hospital stays.

The Henry Ford study was published this week in European Urology, the official journal of the European Association of Urology.

"The study demonstrated that there's a two-pronged benefit," says Craig G. Rogers, M.D., director of Renal Surgery at Henry Ford Hospital's Vattikuti Urology Institute.

"Our goal was to protect the kidney from damage during a minimally invasive partial nephrectomy, and from a cancer standpoint, we have the added security that we've removed more of the tumor."

In the latest research, Henry Ford surgeons used robotic techniques to operate on seven kidney cancer patients between April and September 2012. In each case, they performed a partial nephrectomy, in which just the cancerous portion of the kidney is removed.

"What we've done is utilized a special type of device called a GelPoint trocar, that makes it easier to pass large things in and out of the abdomen through small incisions during minimally invasive surgery," says Dr. Rogers.

"Through the gel point, we take a syringe that's been modified so we can pack and deliver ice through the body to the kidney. So when we clamp the blood supply to the kidney, it's packed in ice just as it would be in an open surgery.

"Once the tumor is removed, instead of setting it aside in the body so you can sew up the kidney, we can remove the tumor as soon as it's excised through the gel point, look at it and decide if we're happy with what's been removed. If there's any doubt, I can go right back in and cut more out."

Dr. Rogers wrote in the study that others have tried various techniques to cool the kidney in minimally invasive surgery, but they "require specific equipment or expertise and are too complex or impractical for routine use."

"Unfortunately, the majority of people today diagnosed with kidney cancer get their entire kidney removed," Dr. Rogers says. "Not only that, they're getting it removed through an open approach, though a large incision that often requires removal a rib, when there are minimally invasive approaches, such as robotic surgery, available."

One of the reasons more patients aren't given the option of a partial nephrectomy is because for the surgeon, it's technically challenging to do and much more difficult to perform than taking the entire kidney out.

Dr. Rogers explains: "In order to safely perform a partial nephrectomy, surgeons often have to clamp off the blood supply to the kidney to allow them to see the tumor and cut it out in a bloodless field. But once the blood supply is cut off to the kidney, there's only about 30 minutes before the kidney can experience irreversible damage. That means the surgeon has to be very technically skilled to remove the tumor, and sew the kidney back together in a very short time.

"Time is a barrier for many surgeons to offer the partial nephrectomy procedure to their patients. Or, for those who do, they'll offer the open approach to a partial nephrectomy, which means a bigger operation for the patient. There are two things surgeons who perform open nephrectomies have been able to claim, up until now, that they could do which minimally invasive surgeons could not.

First, when the surgeon is holding the kidney in the open approach and the clamp goes on the kidney to stop the blood flow, he can pack the kidney on ice to cool it, called renal hypothermia. It allows the surgery to extend the window of time he has to work without kidney damage," says Dr. Rogers.

The other claim is that when the tumor is cut out, the surgeon can hold it and analyze it, to make sure that he is happy with what's been removed before sewing the kidney back up.

"Before, with a minimally invasive partial nephrectomy, it was very hard to get ice in through the small incision and to get the ice to stay where you want it. And then once the tumor's cut out, you really can't take it out of the body right away and look at it," says Dr. Rogers.

"The reason why I'm so excited about what we've discovered and innovated at Henry Ford is that it cuts to the core of the real problem. We can now offer more patients partial nephrectomy through a minimally invasive approach. So any technology that allows patients to get a better surgery and a better outcome in a less invasive way, is going to be something that will benefit everyone."

Note: You may request a pdf of the study or go online at http://www.sciencedirect.com/science/article/pii/S0302283812013607.

Dwight Angell | EurekAlert!
Further information:
http://www.hfhs.org

More articles from Medical Engineering:

nachricht Rutgers researchers develop automated robotic device for faster blood testing
14.06.2018 | Rutgers University

nachricht Speech comprehension with a cochlear implant
04.06.2018 | Universität zu Lübeck

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: AchemAsia 2019 will take place in Shanghai

Moving into its fourth decade, AchemAsia is setting out for new horizons: The International Expo and Innovation Forum for Sustainable Chemical Production will take place from 21-23 May 2019 in Shanghai, China. With an updated event profile, the eleventh edition focusses on topics that are especially relevant for the Chinese process industry, putting a strong emphasis on sustainability and innovation.

Founded in 1989 as a spin-off of ACHEMA to cater to the needs of China’s then developing industry, AchemAsia has since grown into a platform where the latest...

Im Focus: First real-time test of Li-Fi utilization for the industrial Internet of Things

The BMBF-funded OWICELLS project was successfully completed with a final presentation at the BMW plant in Munich. The presentation demonstrated a Li-Fi communication with a mobile robot, while the robot carried out usual production processes (welding, moving and testing parts) in a 5x5m² production cell. The robust, optical wireless transmission is based on spatial diversity; in other words, data is sent and received simultaneously by several LEDs and several photodiodes. The system can transmit data at more than 100 Mbit/s and five milliseconds latency.

Modern production technologies in the automobile industry must become more flexible in order to fulfil individual customer requirements.

Im Focus: Sharp images with flexible fibers

An international team of scientists has discovered a new way to transfer image information through multimodal fibers with almost no distortion - even if the fiber is bent. The results of the study, to which scientist from the Leibniz-Institute of Photonic Technology Jena (Leibniz IPHT) contributed, were published on 6thJune in the highly-cited journal Physical Review Letters.

Endoscopes allow doctors to see into a patient’s body like through a keyhole. Typically, the images are transmitted via a bundle of several hundreds of optical...

Im Focus: Photoexcited graphene puzzle solved

A boost for graphene-based light detectors

Light detection and control lies at the heart of many modern device applications, such as smartphone cameras. Using graphene as a light-sensitive material for...

Im Focus: Water is not the same as water

Water molecules exist in two different forms with almost identical physical properties. For the first time, researchers have succeeded in separating the two forms to show that they can exhibit different chemical reactivities. These results were reported by researchers from the University of Basel and their colleagues in Hamburg in the scientific journal Nature Communications.

From a chemical perspective, water is a molecule in which a single oxygen atom is linked to two hydrogen atoms. It is less well known that water exists in two...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Munich conference on asteroid detection, tracking and defense

13.06.2018 | Event News

2nd International Baltic Earth Conference in Denmark: “The Baltic Sea region in Transition”

08.06.2018 | Event News

ISEKI_Food 2018: Conference with Holistic View of Food Production

05.06.2018 | Event News

 
Latest News

A sprinkle of platinum nanoparticles onto graphene makes brain probes more sensitive

15.06.2018 | Materials Sciences

100 % Organic Farming in Bhutan – a Realistic Target?

15.06.2018 | Ecology, The Environment and Conservation

Perovskite-silicon solar cell research collaboration hits 25.2% efficiency

15.06.2018 | Power and Electrical Engineering

VideoLinks
Science & Research
Overview of more VideoLinks >>>