Introduction

Robotic radical nephrectomy (RRN) has become a standard surgical approach for localised Renal Cell Carcinoma (RCC), offering benefits such as reduced postoperative pain and quicker recovery. This case study presents a 45-year-old male diagnosed with a renal mass, managed successfully with RRN by Narayana Health’s leading Nephrology Department.

Case Presentation

Patient Profile:
Age: 45 years
Sex: Male

Medical History: This 45-year-old gentleman was admitted to our hospital with a history of left flank pain for which a PET CT scan was done, which revealed a hypermetabolic heterogenously enhancing centrally necrotic exophytic soft tissue density mass lesion arising from the lower pole of the right kidney, suggestive of renal cell carcinoma, likely clear subtype. There were no significant hypermetabolic abdominal lymph nodes or no evidence of distant metastasis in this study.

Surgical Procedure

Technique:

The robotic radical nephrectomy was performed under general anaesthesia using the da Vinci surgical system.

Positioning: The patient was placed in a modified lateral decubitus position.
Ports Placement: Four robotic ports were placed on the left side, and one assistant port was included for suction and retraction.

Procedure Steps:

The renal artery and vein were identified and dissected free from surrounding tissues. The right kidney and pelvis were mobilised, and the upper ureter was dissected. The right kidney was removed, and the adrenal was spared. A tube drain was placed, and a specimen was retrieved.

Postoperative Care

The patient was monitored in the recovery unit and could resume oral intake within a few hours post-surgery. His pain was managed with oral analgesics, and he was mobilised on the next day and discharged after evaluation.

Hospital Stay: The patient was discharged on postoperative day 1 with instructions for follow-up.

Discussion

Robotic radical nephrectomy is an effective and safe approach for managing localised RCC. Compared to open surgery, it offers advantages such as reduced blood loss, shorter hospital stays, and quicker recovery times. This case illustrates the successful application of RRN in a middle-aged male with a renal mass, emphasising the importance of a multidisciplinary approach and careful preoperative planning.

Conclusion

This case study demonstrates the successful management of renal cell carcinoma in a 45-year-old male using robotic radical nephrectomy. With ongoing advancements in robotic surgical techniques, RRN remains a vital option in the treatment of localised kidney cancer, offering favourable outcomes and improved quality of life for patients. The uniqueness of this case is that the patient was discharged on the very next day the patient got operated on, which is rarely seen in such complex surgeries. He is presently under regular follow-up and is doing well after the surgery.

Trust Narayana Health's Nephrology Department for advanced, patient-centred care in kidney cancer treatment. This case highlights our expertise in robotic surgical techniques, which provide effective solutions with minimal recovery time, ensuring better outcomes and enhanced quality of life.

Schedule a consultation today to explore how our expert Nephrologists can comprehensively support your renal health needs.