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robotic partial nephrectomy

VeryAnxious
Posts: 67
Joined: Sep 2010

I am awaiting a robotic partialnephrectomy for a 1 inch mass near in my upper pole near the renal pelvis and vein. had 2 opinions. Have not seen many posts on this Any one had this surgery and how did it go. Of course, they may have to take out the kideny depending on how things go. The decisions and wait are the worse. Oct 1 for me. I am being told the surgery could take up to 5 hours? Any feedback is appreciated.

pbjoseph1
Posts: 10
Joined: Aug 2010

My husband is in the same position. His tumor is about 3.5cm but near the renal artery and vein. He is going for surgery on the 23rd. We have had 3 opinions and have chosen the best surgeon possible. Apparently it is in the worst position possible but the surgeon will attempt to do it laporoscopically with the very real possibility of it needing to be opened up. The waiting is very stressful. The surgeon said he could remove the whole kidney laparoscopically but they prefer to save part of the kidney is possible, even if that means needing to be opened up.

VeryAnxious
Posts: 67
Joined: Sep 2010

Well good luck. the 23rd of Sept? How did you choose your surgeon. I went with who seemed to have the better attitude. Just about the same thing they said to me. ARe you doing it robotically. they told me it was a good choice for me. You too? My undetstanding is if they have to take the kidney, since they are small mine is 3 cm, it will still be okay. good luck to you and keep me posted. How did you decide on which doctor to go with.

DianaLou
Posts: 30
Joined: Nov 2009

I am having the same proceedure as you, on Sept. 20. I have a 7 cm tumor in my right kidney. I will keep you posted on how my proceedure went. I went to a well known cancer center in my area. I felt more secure with that option, as I live in a rural area with only one hospital, I felt the cancer center would be better equipt to handle my case. Good luck to you. I was told 3 1/2 to 4 hours for my surgery.

VeryAnxious
Posts: 67
Joined: Sep 2010

Yes please keep me posted and I wish you the best of luck. I am guessing mine was quoted as much longer since it is by the renal pelvis and major artery. Very complicated. did they give you any idea if they might have to revert to open or not. Did you ever second your decision of doctors. I amthinking I have too much waiting time on my hands. the surgeon seems confident and I like the fact that I can email him and he responds back quickly. this ordeal started at the end of June for me. We all must keep a positive attitude. What area are you in. Usually you have to travel to get to the cancer centers.

DianaLou
Posts: 30
Joined: Nov 2009

My doctors did advise me that there would be a chance to revert to the traditional surgery. They wouldn't know for sure until the surgery begins. I was first diagnosed by a local urologist, after I went to the ER locally with severe abdominal pain. I requested to be referred to a well known cancer center 75 miles away from my home. Lucky to have one so close. Keeping a positive attitude is half the battle. I need to recover so I can travel across the country for Christmas with my grandkids. That is my goal right now.

VeryAnxious
Posts: 67
Joined: Sep 2010

Please keep me posted. A positive attitude is essential. A person once told me(cancer patient), it is what it is and just accept it and put your faith in the Lord. We can not change things. You are lucky to have a cancer center so close. They are all out of state for me. Yoiu should be fine for Christmas and it will make the trip that much more special.

VeryAnxious
Posts: 67
Joined: Sep 2010

Please keep me posted. A positive attitude is essential. A person once told me(cancer patient), it is what it is and just accept it and put your faith in the Lord. We can not change things. You are lucky to have a cancer center so close. They are all out of state for me. Yoiu should be fine for Christmas and it will make the trip that much more special.

sue406
Posts: 12
Joined: Sep 2010

I'm considering the same surgery in a couple of weeks, for a 2.7 cm mass that may or may not be cancerous. I'm hoping all went well for you, DianaLou. If you or anyone who has had the surgery can share your experiences, post-surgery, I would love to get a better sense of what might be ahead.

VeryAnxious
Posts: 67
Joined: Sep 2010

am going in on Friday. Will post as soon as I can. anxiety is really setting in. Where is yours located. That may be my only problem. good luck

VeryAnxious
Posts: 67
Joined: Sep 2010

am going in on Friday. Will post as soon as I can. anxiety is really setting in. Where is yours located. That may be my only problem. good luck

VeryAnxious
Posts: 67
Joined: Sep 2010

am going in on Friday. Will post as soon as I can. anxiety is really setting in. Where is yours located. That may be my only problem. good luck

VeryAnxious
Posts: 67
Joined: Sep 2010

am going in on Friday. Will post as soon as I can. anxiety is really setting in. Where is yours located. That may be my only problem. good luck

sue406
Posts: 12
Joined: Sep 2010

I'm not sure exactly where mine is, other than "the lateral aspect of the middle third" of the kidney. Some of the MRI reports have said it's near the junction of the upper and middle thirds. In talking with someone from the doctor's office tonight, he told me it's growing into the kidney and is very close to the urine collection system, making it a little bit more difficult for the operation. However, he said he's rarely seen a procedure that's had to convert to open surgery. I'm sure you've probably been told that a conversion to open surgery is possible if they can't control any bleeding with the laparoscopic instruments, or if the mass is centrally located and close to the collecting system. He also said if mine had to go to open surgery, it's likely there would be an incision in the abdomen, but not one going from the abdomen to the back. He didn't think that removal of a rib would be necessary, as it is with the traditional open surgery.

He estimated the surgery would be 2-3 hours, but could be longer if any "positive margins" were found through a biopsy and more of the kidney needed to be removed.

I think surgeons sometimes tend to sugarcoat what the recovery will be like, so I tried hard to find out more. He gave me the rundown of all the usual complications of anasthesia and surgery. But he also said the hospital stay could be as short as two days, if all goes well. However, it could be three months or so before you're back to normal energy levels. He also did say that some people have pain/tingling feelings around the incisions and that feeling can last for months or never go away.

Has your doctor determined for sure that the growth is malignant, or is it just "suspicious," which is what mine has been for three years now. Six MRIs have shown slow growth but little enhancement, so I'm really struggling with a decision on whether to do the surgery or just keep waiting.

icemantoo's picture
icemantoo
Posts: 1618
Joined: Jan 2010

Sue 406:

You have been strugling with the decision to have or not have the Surgery. I have already weighed in with my opinion. What do I know? I am not a Doctor. Ask your Doctor if these were his test results would he have the Surgery now.

sue406
Posts: 12
Joined: Sep 2010

I have asked that question. He's consistently said that he wouldn't recommend surgery for a 75 or 80 year old, and would probably want his wife to just have the continued monitoring because of the risks of the surgery. At this last visit, he said he would still recommend against surgery for an 80-year-old, but it's a harder call for a person my age (52). Because the MRIs are showing slow growth, he said it's it's harder to recommend no action at my age, in case it is cancer and would eventually spread. However, he did say I could wait another six months and have another MRI if I wanted.

He's always said the mass is in the "meat" of the kidney and that poses more problems for laparoscopic surgery. My sense at this particular moment on this particular day, is that surgery may be inevitable at some point, and it may be better to do it sooner rather than later. I'm not sure what would happen if it continued to grow and got even closer to the collection system or into it. But I'm having a hard time making a decision....

icemantoo's picture
icemantoo
Posts: 1618
Joined: Jan 2010

If the surgery is inevitable it is a lot easier at 52 than 62. My doctor's answer to the survival rate now that everything was taken care of, is that I will die of something else.
The mass is only going to get bigger and more complicated although that may take a couple of years. As these things happen the surgery options become more limited. While the surgery is not fun you should be back to a normal routine in 6 weeks or so. Read the 75 posts under recovery from nerhactomy to get a balanced perspective of post surgery.

VeryAnxious
Posts: 67
Joined: Sep 2010

sounds so very much like what I have been told. You asked some different questions than I did and I was interested to hear your answers. I also struggled with the surgery. I am going in on Friday. I am too afraid to wait. I am almost 55. One doctor told me ti was 90% probable malignancy and this one said he was convinced it had malignant potentional. I once we make the decision by constantly second guessing ourselves, which is what I have been doing for the past 20 weeks, we drive ourselves crazy. Mine did say the longer we wait the easier it is to find robotically. Did you get a second opinion.
At this point I cam going to hpe for the best. I will email my doctor some more questions tonight. He responds very quickly that way. Are you also talking robotically or laprascopically. I get the two confused at times. Good luck. You are so not alone. No one quite understands unless you are in our shoes.

sue406
Posts: 12
Joined: Sep 2010

The waiting didn't bother me for three years, but like you, I have found it so difficult to make the decision. The first doctor I saw wanted to take it out right away, but the second opinion (at Mayo) was to wait and see whether it changed at all. I'm traveling 1,200 miles to go to Mayo in Arizona, but my parents live there so that's a big plus.

Iceman, thanks for your thoughts. I think you're right. I just need to get it over with.

VeryAnxious, I'd love to hear what more you might learn from your doctor. The surgery as planned right now is both robotic and laparoscopic, and I will keep my fingers crossed for both of us that there is no need to convert to open surgery.

pbjoseph1
Posts: 10
Joined: Aug 2010

I had my surgery 8 days ago. Going in, we weren't sure if surgery was going to be laproscopic or open. The other area we weren't sure of was weather part of the kidney would go, or the entire thing.

Surgery went robotic, and only lost 20% of the kidney. The pain wasn't what I expected either. I thought it would be sharp and horrible. Instead, it felt like I had strained my abdominal muscles by doing thousands of sit ups.

My tumor was on the upper pole of the left kidney, and just touching the renal vein. My pathology came back as type T1A stage 2 with clear margins. All seems to be good at this point. I have a follow up next Wednesday.

After 8 days of surgery, I'm feeling much, much better physically. Good luck to all the others still pending surgery in here. I hope I can be of inspiration to you all. For all the others who have had surgery, I wish you continued good, clear scans and best wishes.

icemantoo's picture
icemantoo
Posts: 1618
Joined: Jan 2010

pbjoseph1, Glad to see you are doing better. And it all started with your wife complaining about a rotten egg. You should be able to get around for a few hours each day although it may take a month or more to get your stamia back.

Icemantoo

sue406
Posts: 12
Joined: Sep 2010

pbjoseph1, I'm glad to hear that the surgery went well and that you're recovery appears to be going well, also. Your experience gives me hope and courage for my upcoming surgery.

VeryAnxious
Posts: 67
Joined: Sep 2010

Got home Tuesday night after 5 days in the hospital. did the surgery robotically. i was in 6 hours. Was never alert to talk to the surgeon. The surgery itself was not bad. I am narcotic sensitive and had a horrible reaction to the painmeds and had to be put onoxgyn and stayed in the hospital longer because of this. The doctor removed a cyst which was cancer free what he thought and has sent the speicmen to the lab. Amgoing back Monday.
I am simply trying to regainmy strength. After coming home, I took one more horrible pain pilland was able to get the with minimal pain. My only problems are shortnesss of breath exhaustion and tire so easily. But I am babying myself for the first time in 55 years.
Need to find out how much of the kidney he took out.

VeryAnxious
Posts: 67
Joined: Sep 2010

I wrote that wrong. The fatty cyst was oky.. The lesion by the pelvic artery we are awaiting.

VeryAnxious
Posts: 67
Joined: Sep 2010

went for my follow up today. I forgot the number of the cancer it started with a T and was Stage 2. The doctor said he got it all. When I asked abou the magins, he said on tumor was lying right on top of the renal pelvic vein (I think it is called) so that side would not have clear magins since he scooped it right up. He seemed very confident, but I am still worried. Does this sound right? The thought of having to go thru this again just makes me so depressed, I can not stand it.
It wants to do a chest xray this week, since I have been compalining of shortness of breath.
Then if no problems see me in 3 months, in which I do a a nuclear renal xray and blood tests
Since the surgery was so complicated, he said the best he could hope for was 40 - 45% kidney function..
I think I am just going thru a down phase after all of this started in June. I feel so overwhlmed

VeryAnxious
Posts: 67
Joined: Sep 2010

went for my follow up today. I forgot the number of the cancer it started with a T and was Stage 2. The doctor said he got it all. When I asked abou the magins, he said on tumor was lying right on top of the renal pelvic vein (I think it is called) so that side would not have clear magins since he scooped it right up. He seemed very confident, but I am still worried. Does this sound right? The thought of having to go thru this again just makes me so depressed, I can not stand it.
It wants to do a chest xray this week, since I have been compalining of shortness of breath.
Then if no problems see me in 3 months, in which I do a a nuclear renal xray and blood tests
Since the surgery was so complicated, he said the best he could hope for was 40 - 45% kidney function..
I think I am just going thru a down phase after all of this started in June. I feel so overwhlmed

blackbelt's picture
blackbelt
Posts: 32
Joined: Apr 2006

I had a open partial nephrectomy on 5/17/2006 at the age of 51, renal cell carcinoma, clear cell type, Fuhrman grade 2, stage I, 1.2 cm right renal mass, with complications, doctors nicked right lung and nicked lower abdominal peritoneum area, this kind of surgery was high risk high return because of location of kidney tumor!

VeryAnxious
Posts: 67
Joined: Sep 2010

thanks for your responses. I guess at this point, I will wait for my 3 month nuclear renal test and bloods and take it from there. Right now I am still recovering from the surgery. It is taking me longer, since the worrying is just awful. I guess I will e mail the doctor, and ask some questions. I feel he is getting distant, but it is probably my imagination.

sue406
Posts: 12
Joined: Sep 2010

I had robot-assisted laparoscopic surgery a week ago, on Oct. 14. I went home from the hospital feeling sore and tired, but generally OK, about 50 hours later, on Oct. 16. I was down to one pain pill a day after that and have been using nothing but Tylenol, three times a day, since Tuesday. I am astonished at how quickly my recovery seems to be progressing. I hardly have any pain, except soreness in the kidney area when the Tylenol starts to wear off.

There was a mix-up with scheduling of my post-op appointment yesterday, however, and I essentially was out of my house for 7.5 hours waiting for the appointment to happen. That taught me that while I might be feeling OK, I'm certainly not up to a full day's worth of activities. I plan to continue the walking/resting routine until I've regained most of my strength.

As many others have said in this and other posts, I believe the success of the surgery depends on a lot of factors, including the surgeon's experience with the equipment and the location of the mass. Despite numerous MRIs over three years showing that the mass was in "the meat" of the kidney, it turns out that much of it was outside of the kidney. The doctor says I still have 90% of the kidney. The mass also turned out to be benign, making me even happier that I had the ability to choose a less invasive operation. It may not be for everyone, but I certainly believe the laparoscopic option has been a terrific one for me, and I'm thankful I had the opportunity available.

One question for those who have gone through surgeries, though--is six months a normal time to wait for a renal function test and renal scan? That's what my doctor suggested yesterday, and I don't know if that's because I live in another state and he wanted to minimize travel demands, or if that's generally normal.

VeryAnxious
Posts: 67
Joined: Sep 2010

Mine is doing it a 3 months. The nuclear renal scan and a lot of blood tests, but maybe since my kidney function will be less. I also took very little in the way of pain medicine, but I find I still after 3 weeks get so tired so very quickly. I am guessing it is normal I was in surgery for 6hours

VeryAnxious
Posts: 67
Joined: Sep 2010

Mine is doing it a 3 months. The nuclear renal scan and a lot of blood tests, but maybe since my kidney function will be less. I also took very little in the way of pain medicine, but I find I still after 3 weeks get so tired so very quickly. I am guessing it is normal I was in surgery for 6hours

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