Robotic partial nephrectomy: the most advanced surgery for kidney cancer

• This surgery allows patients to lead a normal life with both kidneys working, without needing dialysis.
• Renal cell carcinoma is the most common form of kidney tumour in adults, accounting for 85% of all kidney cancers.

March 2023 – Kidney cancer develops when the cells that make up the kidney change, divide and grow out of control. Over time, these cells form a mass called a tumour. The risk increases with age.

There are different types of kidney cancer, the most common in adults being renal cell carcinoma (RCC), which accounts for 85% of all kidney cancers.

RCC usually develops as a single tumour in one kidney, although it can affect both. This was the case for Andrea Castellano, a 36-year-old Venezuelan mother of two girls, who underwent robotic partial nephrectomy surgery at Cleveland Clinic Florida, performed by Dr. Alberto Pieretti.

Andrea was diagnosed by a urologist in Venezuela, who ordered an ultrasound of her kidneys after she came in for cystitis. To everyone’s surprise, a mass was found in her right kidney, and after a CT scan, a computed tomography scan, it was confirmed that she had a malignant tumour called renal cell carcinoma.

After being assessed by several oncologists in her home country, many suggested she would have to have her whole right kidney removed. But they also told her that in the United States her kidney could be saved, so she did not hesitate to go to Cleveland Clinic Florida, where she met Dr. Pieretti, who told her about robotic partial nephrectomy surgery, in which only the affected part of the kidney is removed.

“Robotic partial nephrectomy is a type of surgery in which part of the kidney is removed to treat a disease or injury. Once your surgeon corrects the condition, they will reconstruct your kidney,” explained Pieretti.

Andrea had the surgery at the end of September 2022, with successful results, and is now cancer-free. “She will now live a normal life with both kidneys working, without needing dialysis,” said the specialist.

The surgeon added that most people recover fully within four to twelve weeks, depending on the type of procedure. He said this cancer is unusual in someone so young and that the tumour was found incidentally; Andrea’s cystitis was not a symptom of her renal cell carcinoma.   

Other types of kidney cancer include transitional cell cancer: this accounts for 6% to 7% of all kidney tumours. It usually starts in the area where the ureter connects to the main part of the kidney, and can also occur in the ureters or bladder.

Renal sarcoma: this is the least common form of kidney cancer, accounting for only 1% of cases. It starts in the connective tissues of the kidneys and, if left untreated, can spread to nearby organs and bones.

Wilms tumour: this is the most common type in children. It accounts for around 5% of kidney cancers.

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About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical centre that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based on the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States.  

U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 72,500 employees worldwide are more than 5,050 salaried physicians and researchers, and 17,800 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties.  Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 21 hospitals, more than 220 outpatient facilities, and locations in northeast Ohio; southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England.

 In 2021, there were 10.2 million outpatient visits, 304,000 hospital admissions and observations, and 259,000 surgeries across Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries.  

Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic. News and resources available at newsroom.clevelandclinic.org.

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