When it comes to surgery, less is more. Surgeons are continually finding ways to minimize pain, recovery time and any potential adverse effects from surgery. One way is to limit the number of incisions to as few as possible.

Clayton Lau, right, during a recent minimally invasive robotic surgery (Photo by Alicia Di Rado)

Recently, City of Hope surgeons were among the first to remove a patient’s kidney through only one small cut in the skin with the assistance of a surgical robot. It was the first robotic single-incision kidney removal, or nephrectomy, on the West Coast.

Urologic surgeon Clayton Lau, M.D., clinical assistant professor of surgery, and surgical fellow Vernon Orton, M.D., used the da Vinci S HD Surgical System to remove a patient’s cancerous kidney. The patient was able to return home only three days later and only had to use prescription pain relievers for one day.

“Usually in nephrectomy using robotic, minimally invasive surgery, we make four to six holes and an incision to take out the kidney,” Lau said. “Now, we only have to make one small, 2-to-2½-inch incision. That means less trauma to the body and better cosmesis [skin appearance after surgery] — and possibly less pain.”

The surgical team took less than 2½ hours to perform the procedure, he said, about as long as today’s typical robotic nephrectomy.

Nearly 57,800 people in the U.S. this year will learn they have kidney cancer, according to the American Cancer Society. Surgery is the main initial treatment option.

Traditional open surgeries require an incision that can be as large as a foot long, and surgeons may have to remove a rib or go through muscle, both of which need a long recovery. At City of Hope, surgeons perform most kidney cancer surgeries using the da Vinci robot to operate with tiny, precise instruments through small punctures and incisions in the skin. Now the single-incision robotic procedure takes that technology a step further.

Lau believes the future is bright for these minimally invasive surgeries, which will ease the cancer treatment process for patients. As surgeons refine the procedure, said Lau, “I anticipate we will be able to use this technique for most partial and radical nephrectomies.”