Edward doctor performs cutting-edge robotic surgery to treat kidney cancer

At Edward Hospital in Naperville, doctors are using robotics in a new way — in surgery to treat certain complicated cases of kidney cancer.

In about 10 percent of advanced kidney cases, a clot of cancer tissue travels to the veins of the kidney and blocks the organ's main vein, the inferior vena cava. This is a potentially life-threatening complication if the clot, called a thrombus, makes its way to the heart or lungs.

Traditionally, the primary treatment would be an open surgery called radical nephrectomy with vena cava tumor thrombectomy, which involves taking out the kidney and removing the thrombus. Removal of the clot is typically the more complex and challenging part of the procedure. It requires separating the kidney from the surrounding organs for better access, opening the vein, removing the tumor and then reconstructing the vein while carefully using clamps to avoid blood leakage.

Now facilities that have both the da Vinci robotic surgery system and physicians with the appropriate expertise and special training can offer patients a less-invasive option for this highly complex surgery. One of the most advanced surgical technologies available, da Vinci allows the physician to insert miniature instruments and a tiny high-definition 3-D camera through small incisions.

“The system's enhanced magnification helps us see the small vessels on our monitor, and the flexible robotic ‘wrists' give us greater precision as we operate them from the control panel,” said Ranko Miocinovic, a urologist with DuPage Medical Group who performs surgery at Edward Hospital..

Only nine academic medical centers in the country have published that they have done the radical nephrectomy with vena cava tumor thrombectomy robotically, involving a total of 33 patients, according to Miocinovic.

On May 3, Miocinovic performed the first of these surgeries at Edward. The patient was a 57-year-old woman who had gone to the Edward emergency room about a week earlier with extreme pain in her side and blood in her urine. Scans showed it wasn't a kidney stone causing the symptoms as suspected, but rather a large mass on her kidney. She also had a thrombus in her vena cava. Miocinovic was able to perform the surgery through an incision of about three inches.

“Smaller incisions mean less loss of blood and overall fluids. There's a reduction in inflammation and scarring, and typically a shorter recovery,” Miocinovic said. “This patient would not have survived without surgery. She was home two days after the surgery with her chance of being disease-free in five years dramatically improved.”

For information on robotic surgical procedures performed at Edward-Elmhurst Health, visit eehealth.org/services/surgery.