Robotic Assisted Partial Nephrectomy (RAPN)

A “robotic assisted partial nephrectomy” (RAPN) is a minimally invasive surgical procedure performed to treat renal masses which are suspected or confirmed to be kidney cancer. The aim of this operation is to remove only the tumour and leave the remainder of the normal kidney intact. This is particularly indicated in those who have:

The operation is performed using “keyholes” and using the latest da Vinci® Xi robotic surgical system.

Open vs Robotic incisions
Open vs Robotic incisions
The benefits of the robotic approach include:

WHAT DOES THE PROCEDURE INVOLVE?

Once the anaesthetic is delivered the patient, asleep, is placed on the operating table and prepped. A catheter is placed into the bladder. “Keyhole” incisions are made in a line around the level of the belly button, to allow insertion of hollow tubes (cannulas) into the abdomen. Gas is then pumped into the abdomen to obtain a good view around the kidney. The robot arms are then “docked” (attached) to these cannulas and instruments which will be used to perform the procedure are inserted. The surgeon then controls the instruments remotely (via the “surgical console”) to complete the operation. A surgical assistant and scrub nurse assist at the bedside with changing instruments and inserting/removing sutures.

Surgical ConsoleSurgical Assistant

 
The blood vessels supplying the kidney are identified and the tumour is exposed and marked for incision. The artery supplying the kidney is then clamped for a short period (15-30min) to allow for excision of the tumour and suturing the defect to ensure no bleeding. The tumour is then removed via one of the keyhole incisions and the wounds are closed with absorbable sutures. The tumour is sent to the laboratory to be analysed by a specialist pathologist. The patient generally wakes up soon after the procedure in recovery, and if stable goes to the intensive care or surgical ward.

HOW DO I PREPARE BEFORE MY PROCEDURE?

WHAT CAN I EXPECT IN HOSPITAL AFTER THE PROCEDURE?

The aim before discharge is for you to be able to:

WHAT CAN I EXPECT AFTER I AM DISCHARGED?

WHAT ABOUT DIET?

WHAT ABOUT EXERCISE/ACTIVITY?

WHAT ABOUT MEDICATIONS?

WHAT ARE THE POSSIBLE SIDE EFFECTS/COMPLICATIONS?

Occasional/Uncommon
Rare

NOTIFY GM UROLOGY or your GP if you experience any of the following:

FOLLOW UP APPOINTMENT

You should have an appointment to see your doctor in 2-3 weeks. If this appointment time is not given to you on discharge from hospital, please phone GM Urology.
If you have any queries please contact GM Urology on 03 5201 7000 during business hours OR leave a message on the After Hours Urology Paging Service 03 9387 1000