Many middle-aged and elderly men suffer from difficulty urinating. Some see blood in their urine but feel no pain. They mistakenly think it is a trivial matter and avoid medical treatment. They do not know that painless hematuria is an important symptom of kidney cancer. If the tumor can be detected in time and is in the early stage, there is an opportunity to use minimally invasive surgery with a robotic arm to remove part of the kidney, reducing the risk of renal failure that may be caused by total kidney removal, allowing the patient to recover faster while maintaining the quality of life.
Dr. Tan Baochu, a specialist in urology, explained that if the patient does not feel pain when urinating and urinating, and there is blood throughout the process, it is an obvious symptom of kidney cancer, which often occurs in the middle and late stages of cancer. Other signs include low back pain, or shortness of breath or bone pain caused by cancer cells metastasizing to the lungs or bones. Although smoking and obesity are high-risk groups, when symptoms appear at a later stage, is there any chance of catching the cancer early?
Physical examination ultrasound can catch cancer at an early stage
“In recent years, more than half of the kidney cancer cases were discovered during patients’ ultrasound physical examinations, and most of them were in the early stages.” Dr. Tan said that the treatment method for kidney cancer depends on the stage of the cancer, and most of the kidney cancers discovered during physical examinations are In the first and second stages, the tumors are smaller and can be removed through surgery.
Traditionally, as soon as there is kidney cancer, open surgery is performed to remove the entire kidney to avoid the recurrence of cancer cells. However, the surgical wound is large and the remaining healthy kidney tissue will be lost at the same time. Studies have shown that patients with total kidney removal are 20 to 30% more likely to need kidney dialysis in the future than patients with only part of the kidney removed, especially those with diabetes or kidney disease. Those with poorer functioning are at higher risk. Furthermore, some studies have found that if the cancer is stage 1A and the tumor diameter is less than 4 cm, even if only part of the kidney and the tumor are removed, the chance of cancer recurrence and kidney failure will be lower with dialysis. However, the risk of partial kidney resection is slightly higher than that of complete resection. Secondary bleeding and urine leakage may occur after the operation, but it can be followed up and treated.
Removal of part of the kidney to reduce risk of kidney failure
Therefore, with the advancement of medicine, if the size, complexity and location of the tumor, such as being located below the kidney, or protruding at the front below the kidney, etc., laparoscopic minimally invasive or robotic arm minimally invasive surgery will also be considered for cases that meet the conditions for partial nephrectomy. Invasive surgery to remove the tumor by removing part of the kidney.
Dr. Tan said that robotic arm surgery, which has become popular in recent years, is suitable for removing stage 1A kidney cancer tumors. The robotic arm is more precise and flexible than the laparoscope. The artificial wrist of the Da Vinci robotic arm can rotate in seven directions. It can also fine-tune the movement and filter out interference such as hand tremors, making the needle placement position more accurate and precise. Therefore, robotic suturing is faster than laparoscopy, reducing operation time, and also meets the requirements of operations that require repairing more kidney tissue.
The robotic arm accurately places the needle and sews quickly
In addition, the 3D field of view provided by the robotic arm can be magnified ten times to give a three-dimensional effect, making it easier for doctors to operate the knife. For patients, the biggest advantages of robotic arm surgery are thin wounds and fast recovery. Taking kidney cancer resection as an example, only six to seven eight-mm incisions are made in the patient’s abdomen. The patient can be discharged from the hospital about four days after the operation.
Mr. Deng (pseudonym), 50 years old, underwent an ultrasound during a physical examination and found a shadow under his left kidney, which was suspected to be kidney cancer. The tumor and part of the kidney were removed through a robotic arm. The operation took about 3 hours to complete. The tumor belonged to stage 1A kidney cancer.
Dr. Tan said that for the first stage of kidney cancer, if the doctor is experienced, the expected five-year survival rate for both traditional open surgery and robotic arm surgery to remove kidney cancer exceeds 80%.
Doctor Tan reminds us that there are many different treatment options for kidney cancer, each with different effects and side effects. If patients have any questions, they should consult their treating doctor.
▲ Urology specialist Dr. Tan Bao Chu
HKET App has been fully upgraded, and TOPick has launched a series of parent-child, health, entertainment, Hong Kong news and leisure life information and videos for everyone. Download now:
Follow TOPick WhatsApp channel for updates:
Written by : Urology specialist Dr. Tan Bao Chu
Column name: Health Expert Column