Ketan K. Badani, MD, professor of urology, Icahn School of Medicine Mount Sinai, director, Robotic Surgery, Mount Sinai West, vice chairman, Urology and Robotic Operations, director, Comprehensive Kidney Cancer Program, Mount Sinai Health System, discusses the evolution of robotic retroperitoneal partial nephrectomies in renal cell carcinoma (RCC).

Retroperitoneal robotic surgery has long been a topic of discussion in the treatment landscape of RCC, Badani says. However, the evolution of the technology has made a substantial difference compared with tools used to conduct robotic surgery 20 years ago, Badani explains. The current system, the da Vinci XI, and the newest system, the da Vinci SP, allow clinicians to comfortably maneuver all the machine’s arms into the surgical space to conduct a more reliable and reproducible retroperitoneal operation, Badani says.

Older systems made the surgery much more cumbersome, and the new technology has made it easier to integrate these procedures back into practice, Badani concludes.

Videos

Ketan K. Badani, MD, discusses the evolution of robotic retroperitoneal partial nephrectomies in renal cell carcinoma.


Dr. Badani on the Evolution of Robotic Retroperitoneal Partial Nephrectomies in RCC

Ketan K. Badani, MD, professor of urology, Icahn School of Medicine Mount Sinai, director of robotic surgery, Mount Sinai West, vice chairman, Urology and Robotic Operations, director, Comprehensive Kidney Cancer Program, Mount Sinai Health System, discusses the utility of multiport robotic retroperitoneal partial nephrectomies in renal cell carcinoma (RCC). 

Data suggest that robotic surgery is a dominant modality in cancer. Specifically, approximately 70% of all partial nephrectomies are performed robotically in the United States, Badani says. Moreover, most of these surgeries are performed through the abdomen. However, in some scenarios, such as patients with posterior-sided kidney tumors or individuals who had undergone extensive abdominal surgery and have abdominal adhesions and scarring, it is optimal to surgically go in through the retroperitoneum with a retroperitoneal partial nephrectomy, Badani explains. 

 Retroperitoneal surgeries comprise about 5% to 8% of surgeries, but up to 50% of patients could be eligible for this surgical approach because they have posterior-sided kidney tumors or have had abdominal surgeries, Badani concludes.

Ketan K. Badani, MD, discusses the utility of multiport robotic retroperitoneal partial nephrectomies in renal cell carcinoma (RCC).  


Dr. Badani on Utilizing Multiport Robotic Retroperitoneal Partial Nephrectomies in RCC 

Ketan K. Badani, MD, professor of urology at Mount Sinai Hospital, discusses how to determine which patient with renal cell carcinoma (RCC) will benefit from robotic surgery.

Who receives robotic surgery for RCC remains in the hands of the physician, explains Badani. Doing an open partial nephrectomy, a laparoscopic partial nephrectomy, or a robotic partial nephrectomy are all good options when treating a patient.

As a physician’s experience matures with robotic surgery, they will start to see the advantages of it but should offer what they feel comfortable with, states Badani. Most kidney operations done in the United States are not done using robotics.

Dr. Badani on Determining Which Patients With RCC Will Receive Robotic Surgery

Ketan K. Badani, MD, professor of urology at Mount Sinai Hospital, discusses the adoption of robotic surgery in kidney cancer.

The adoption for robotic surgery in kidney cancer has been rising. Just like any operation, though, the surgeon must be comfortable performing the procedure, says Badani.

Safety is of the upmost concern, and there is a learning curve with this technology—so Badani advises starting with more straightfoward tumors and then approaching the more challenging ones to build experience and confidence.

Dr. Badani Discusses the Adoption of Robotic Kidney Surgery

Ketan K. Badani, MD, professor of Urology at Mount Sinai Hospital, discusses the future of robotic surgery for patients with kidney cancer.

There is room for technological improvements in robotic surgery, states Badani. According to Badani, the next logical step forward is for surgeons to detect cancer cells as they are performing surgery.

Additionally, there is a learning curve for complex robotic kidney surgery, explains Badani. The understanding of robotic surgery needs to be spread throughout the United States.

Ketan K. Badani, MD, professor of Urology at Mount Sinai Hospital, discusses the future of robotic surgery for patients with kidney cancer. 

Dr. Badani on the Future of Robotic Surgery for Kidney Cancer

Ketan K. Badani, MD, professor of Urology at Mount Sinai Hospital, discusses the benefits of performing a partial robotic nephrectomy for patients with kidney cancer.

Having a minimally invasive surgery gives patients a quicker recovery time with less pain involved, explains Badani.

Additionally, the surgery is able to protect normal kidney function, which benefits the kidney over a longer period of time, states Badani.

Ketan K. Badani, MD

Articles

Dr. Badani on the Evolution of Robotic Retroperitoneal Partial Nephrectomies in RCC

Dr. Badani on Utilizing Multiport Robotic Retroperitoneal Partial Nephrectomies in RCC

Dr. Badani on Determining Which Patients With RCC Will Receive Robotic Surgery

Dr. Badani Discusses the Adoption of Robotic Kidney Surgery

Dr. Badani on the Future of Robotic Surgery for Kidney Cancer

Dr. Badani on the Benefits of Robotic Surgery for Kidney Cancer