The kidneys are two small fist-sized organs located behind the abdomen on each side of the spine above your waist. By producing urine, kidneys remove toxic by-products and excess fluids from the body to help maintain a critical balance of salt, potassium and acid.

Diseases of the kidney are found more often in racial and ethnic minority populations in the United States than in the Caucasian population. African Americans, Asian Americans, Hispanics/Latinos, and Pacific Islander Americans are three times more likely to suffer from kidney failure than Americans of European descent.

Blockage of the Ureter

One of the most common conditions affecting the kidneys is blockage of the ureter – the tubes that transport urine from the kidneys to the bladder. This condition is found in adults, but more commonly diagnosed in children.

Normally, a single ureter drains a single kidney but sometimes there may be two ureters draining one kidney. One ureter drains the upper part of the kidney and the second ureter drains the lower part. As long as they both enter the bladder normally, this “duplicated collecting system” is not a problem.

In rare cases, a child may be born with an ectopic (abnormally positioned) ureter. This is a ureter that fails to connect properly to the bladder and drains somewhere outside the bladder. In girls, the ectopic ureter usually drains into the urethra or even the vagina. In boys, it usually drains into the urethra near the prostate or into the genital duct system. The urethra is a canal that carries the urine from the bladder and in males also serves as a passageway for semen.

The most common cause of blockage in the urinary tract in children is a congenital obstruction at the point where the ureter joins the renal pelvis — the ureteropelvic junction (UPJ) – the area at the center of the kidney where urine collects and is funneled into the ureter. This problem occurs in roughly one in 1,500 children.1 These obstructions develop prenatally as the kidney is forming and today most are diagnosed on prenatal ultrasound screening. In UPJ obstruction, the kidney produces urine at a rate that exceeds the amount of urine able to drain out of the renal pelvis into the ureter. This causes an accumulation of urine in the kidney. This accumulation, also called hydronephrosis, is visible on ultrasound and often allows the doctor to predict the presence of UPJ obstruction before the baby is born.

Although less common in adults, UPJ obstruction can occur as a result of kidney stones, previous surgery or disorders that can cause inflammation of the upper urinary tract.

Blockages of the ureter can create serious side effects like infections and kidney stones. If left untreated, blockages can cause chronic pain and may damage the kidney over time.

Kidney Cancer

Cancer, a second condition affecting the kidneys, can form in the small tubes inside the kidney. Those tubes located in the center of the kidney where urine collects are used to filter blood.

In the United States, 2 percent of all cancers begin in the kidney.2 Each year, kidney cancer is diagnosed in about 50,000 Americans and is the cause of death in nearly 13,000 Americans. 3 Kidney cancer is slightly more common in men and is usually diagnosed between the ages of 50 and 70 years. The most common kidney cancer is called renal cell carcinoma.

Treatment Options

Non-cancerous kidney conditions such as blockage of the ureter can usually be treated by removing the blockage. Surgery may also be used depending on the type of blockage.

Kidney cancer, on the other hand, is fairly resistant to radiation and chemotherapy. As a result, the gold standard treatment for localized kidney cancer is removal of the kidney or kidney tumors.

Kidney surgery is traditionally performed using an open approach, meaning doctors must make a large abdominal incision. Another approach, conventional laparoscopy, is less invasive, but limits the doctor’s dexterity, vision and control, compared to open surgery.

da Vinci ® for Kidney Conditions

If your doctor recommends surgery for a kidney condition, you may be a candidate for a new, minimally invasive approach – da Vinci Surgery. da Vinci Surgery uses state-of-the-art technology to help your doctor perform a more precise operation compared to conventional surgery. It offers several potential benefits over conventional open surgery, including:

  • Significantly less pain
  • Less blood loss
  • Fewer transfusions
  • Less risk of infection
  • Less scarring
  • Shorter hospital stay
  • Shorter recovery time
  • Increased potential for kidney preservation in certain prescribed cancer operations
  • Better clinical outcomes, in many cases

da Vinci Surgery for kidney conditions incorporates the best techniques of open surgery and applies them to a robotic-assisted, minimally invasive approach.

The precision and dexterity of the da Vinci Surgical System allows for a minimally invasive approach to treating kidney disorders and kidney cancer.

As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient and procedure.

* In Nephrectomy, one incision is enlarged for removal of the kidney.

1. “Ectopic Ureter”, American Urological Association Foundation, www.urologyhealth.org , URL: http://www.urologyhealth.org/pediatric/index.cfm?cat=01&topic=71
2. Ibid.
3. “Cancer Facts and Figures 2008”, American Cancer Society; www.cancer.org , URL: http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf

While clinical studies support the effectiveness of the da Vinci® System when used in minimally invasive surgery, individual results may vary. Surgery with the da Vinci® Surgical System may not be appropriate for every individual. Always ask your doctor about all treatment options, as well as their risks and benefits.

Content provided by Intuitive Surgical. For more information on this topic, please visit www.davincisurgery.com