Expert Guide to Nephrectomy: Robotic Techniques & Kidney Health

Curious about nephrectomy? Join Peter Zombori in a fascinating chat with Dr. Daniel Seiler from Urologie Rotes Schloss in Zurich as they unravel the details of nephrectomy. Discover the compelling reasons behind this surgery, the cutting-edge robotic techniques employed, and the crucial considerations for preserving kidney function while ensuring complete tumor removal.

Peter Zombori: Hello everybody, welcome to our medical talk today. I have the great honor to speak today with Dr. Danny Seiler from Urologie Rotes Schloss in Zurich (Note: also attending physician primarily at Hirslanden Klinik im Park and Hirslanden Klinik), and we will be talking about nephrectomy. Could you maybe describe when you perform a nephrectomy under what conditions?

Dr. Daniel Seiler: Hi Peter, thanks for the invitation and the opportunity to talk to you. It's a pleasure. Nephrectomy normally has to be performed whether you have a larger tumor in the kidney or you have a kidney which is not working anymore, which is damaged and has no function anymore. Nephrectomy is normally tried to be avoided, since we try to preserve as much kidney function as possible.So if, in case, we have a huge tumor, we really have to remove the whole kidney. But in general, we try even if with larger tumors, we try to keep the healthy part of the kidney to preserve the kidney function as much as possible.

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Peter Zombori: And could you maybe get a little bit into detail just on the procedure? How is it done? How do you perform this surgery?

Dr. Daniel Seiler: Mainly, I perform the surgery with the laparoscopic Da Vinci technology, with the robot system. Since we have many advantages to use that system, we have small incisions, and inside the body, we can also move with little instruments to perform this operation. ¹ So it normally takes about—depending on the situation, individually and the tumor size and the way inside of the body everything is more or less performed—it takes about two to two and a half hours to do a partial nephrectomy, meaning that we keep parts of the kidney as much as possible. 

If we just take off and remove completely the kidney, that's a faster procedure. Since then we have only to look for the vessels which lead to the kidney and cut them and take off the kidney, which is a little bit the shorter procedure which takes about an hour, I would say, with that system.

Peter Zombori: And how long is the recovery time after such a surgery?

Dr. Daniel Seiler: Normally they stay in hospital between three and five days, and until they are really back to normal and can do whatever they could do before, I would say it takes about two weeks.

Peter Zombori: And would you say that the surgery, the more you can preserve, the better it is for the patient? Meaning that even complicated tumors can be somehow removed from the kidney and let's say, the affected kidney can still keep its functionality.

Dr. Daniel Seiler: That must be the aim. I mean, the first aim you ever have in an operation, in oncological surgery, is always to get rid of the tumor. So the oncological safety is first, meaning that we definitely have to guarantee the patient that we have the tumor completely removed. But very closely to that, we try to preserve the kidney function as much as possible, and mostly it can be performed, but sometimes we have really complicated situations where the tumor is, for instance, infiltrating the vessels or something.

So we can't really guarantee the patient to have a good blood supply for the kidney anymore. So even with smaller tumors, when they are in a bad position, then we sometimes have to remove the kidney. But the first aim should always be to keep the kidney.

Even if it's, let's say, only half of the function at the end of the day, it's still better than losing a kidney. It will be a pleasure for me.

Peter Zombori: Dr. Seiler, thank you for the insights. I appreciate a lot you sharing all this information with us, and hopefully we can talk very soon about another urological topic. Thank you very much.

Dr. Daniel Seiler: Thanks for having me. And goodbye.