Urologists Performing Minimally-Invasive Surgery for Kidney Cancer

Murray, Utah (10/1/2008) — About 95 Percent of Patients are Candidates for Procedure, But Few Know About Option

State legislator DeMar "Bud" Bowman was taking a break from debate on Capital Hill in February when severe stomach pain and blood in his urine sent him to the emergency room at LDS Hospital. Within days, he was diagnosed with a grapefruit-sized tumor in his kidney, had the organ removed, and was back to work for the final sessions of the Legislature.

"I was in the hospital for three days. After they let me out, I asked my doctor if I could go back up on the Hill. He said, 'Go up and show them how tough you are,'" he recalls. "I got great care, great care."

But he is among a small minority who receive such care.

Bowman suffered from kidney cancer, which usually involves the full or partial removal of a kidney. Traditionally, a surgeon would make a 10- to 12-inch incision – often stretching from the center of a patient's abdomen to the mid-back – cut through six muscles, and remove a rib to reach the kidney. The procedure is complicated, leaves extensive scarring, and involves a long and often painful recovery.

Less Recovery Time

But now there is a less invasive procedure being performed by urologists at Intermountain Medical Center that eliminates major surgery and a long recovery time for patients.

Jay Bishoff, MD, and urologists at the Intermountain Urological Institute at Intermountain Medical Center in Murray, are treating kidney cancer patients like Bowman with a minimally invasive surgical procedure that improves safety and dramatically decreases recovery time. They use laparoscopic equipment and make only four small incisions in the abdomen, leaving the ribcage and all muscle intact.

"Laparoscopic nephrectomy is a wonderful options for patients with kidney cancer," says Dr. Bishoff. "But very few patients receive this care. It's a shame because laparoscopy is so much safer and gets patients back on their feet within just a couple of days, as opposed to a few months."

Some 30,000 people nationally are diagnosed with kidney cancer each year. About 95 percent of them are candidates for laparoscopy, but less than three in 10 in Utah are treated with the technique.

"Patients need to ask their doctor if laparoscopy is right for them and if their physician can do the procedure," says Dr. Bishoff.

Less Invasive Procedure Beneficial For Many Patients

• The procedure is beneficial for elderly patients, who need to get back on their feet as quickly as possible to avoid further complications.
• It's also very valuable for patients with obesity, who often have a harder time healing from the massive incision made during open surgery.
• It also has benefits for diabetics, who do better on dialysis if more of the kidney is preserved.

The urologist who performs the surgery must be skilled in laparoscopic techniques, in which three instruments and a tiny camera are inserted into the belly through four very small openings. Using the camera to guide their hands, surgeons will find the affected kidney, cut away the cancerous area or the entire organ, "catch" it with something like a plastic fishing net, and remove it through an opening.

The physicians at the Intermountain Urological Institute at Intermountain Medical Center are among the small handful of doctors in Utah trained in the procedure. The institute was created in July 2007 to combine the urology resources of three campuses – LDS Hospital, Intermountain Medical Center, and the Salt Lake Clinic. Physicians are also on the staff of the Hunstman Cancer Center and are active in research, participate in clinical trials, develop new protocols and learn the latest advanced techniques. Besides laparoscopy, the team is using the Da Vinci robot in some cases and is leading the way in renal cell cancer in Utah.

The urology team at LDS Hospital was ranked in the top 5 percent of urology programs nationally in 2007. The institute hopes to build upon that reputation, while they standardize their approach to urology care, improve patient access, and make the newest treatment options available for more patients.