New cooling technique for robotic surgery performed on difficult kidney stone

August 27, 2013, Henry Ford Health System

A first-ever technique using ice slush and minimally invasive robotic surgery to remove a particularly large type of kidney stone has been reported by urologists at Henry Ford Hospital.

Dubbed RANL, for robotic anatrophic nephrolithotomy, the technique was devised to remove staghorn calculi – large with sharp, craggy branches – that can cause disease and sometimes death if left untreated.

In a study to be published in the Journal of Endourology, researchers at Henry Ford's Vattikuti Urology Institute and Muljibhai Patel Urological Hospital (MPUH) in Gujarat, India, described their new technique as "a safe, minimally invasive option that may be considered in patients with staghorn stones."

"The shape and size of these stones make them difficult to remove even using conventional percutaneous ," says Khurshid R. Ghani, M.D., of the Vattikuti Urology Institute at Henry Ford Hospital.

Percutaneous, or minimally performed through small in the skin, offer their own challenges in trying to remove all of the stone during a single operation. Sometimes multiple operations spaced over weeks or months may be needed to remove all of the stone from the .

Icing the kidney can protect it from deterioration and provide a longer surgical window during blood flow stoppage, called ischemia. Earlier Henry Ford research led to a cooling method to protect kidneys during minimally invasive robotic surgery. That procedure, ICE (Intracorporeal Cooling and Extraction), was used to robotically remove the diseased portion of a cancerous kidney in several patients. To protect the kidney during its ischemic "down time," a sterile ice slurry was passed through special delivery syringes and a small surgical port to cover the organ.

Craig G. Rogers, M.D., of the Vattikuti Urology Institute at Henry Ford, previously described the ICE technique and is a co-author of this study.

"We developed the ICE procedure to provide kidney protection during ischemia to allow time to perform increasingly complex robotic kidney cancer surgeries. This study extends that technique to allow for complex kidney stone surgeries," says Dr. Rogers.

Dr. Ghani says, "Removing large stones from the kidney requires a bloodless field and longer ischemic times than when removing kidney tumors. This can now be achieved with the ICE procedure during robotic surgery. The hope is that all of the stone can be removed during a single operation."

Using ice-cold ischemia for the robotic removal of staghorn kidney stones had never been done before, but the Henry Ford and MPUH teams succeeded in performing it on three patients, without complications, as described in the new research study.

This breakthrough was possible by combining the expertise of the Henry Ford team with the expertise of doctors from MPUH, which has the world's largest experience in staghorn stone surgery.

The researchers cautioned that while their work showed the feasibility of using the technique, more research is needed to refine the procedure while developing new robotic instrumentation and equipment adapted for the specific purpose.

Explore further: New technique for minimally invasive robotic kidney cancer surgery

Related Stories

New technique for minimally invasive robotic kidney cancer surgery

December 13, 2012
Urologists at Henry Ford Hospital have developed a new technique that could make minimally invasive robotic partial nephrectomy procedures the norm, rather than the exception for kidney cancer patients. The technique spares ...

Robotic ultrasound gives surgeon more direct control in mapping and removing kidney cancers

July 9, 2013
While the use of ultrasound to identify tumors during kidney cancer surgery is gaining acceptance, a research team at Henry Ford Hospital has successfully taken it a step further by showing an added benefit when the procedure ...

Robot-assisted kidney cancer surgery offers many benefits, but at a cost

May 7, 2013
Robot-assisted surgery to remove kidney cancers has seen a rapid increase in use, and has both replaced and proven safer than laparoscopic procedures for the same purpose, according to a study by the Vattikuti Urology Institute ...

Women at increasing risk of kidney stones, related ER visits

August 26, 2013
The risk of women developing kidney stones is rising, as is the number of cases being seen in U.S. emergency departments, while the rate of hospitalization for the disorder has remained stable.

Kidney stone surgery: More women, more complications with minimally invasive procedure

March 27, 2013
While the number of people – especially women – who have a minimally invasive procedure to remove kidney stones has risen in recent years, so has the rate of complications related to the surgery, according to a published ...

Recommended for you

Surprise finding—for very sick elderly, lighter sedation won't drop risk of postoperative delirium, study suggests

August 13, 2018
Johns Hopkins Medicine researchers say a study designed to see if reducing the amount of anesthesia reduces the risk of postoperative delirium in older patients surprisingly found that lighter sedation failed to do so in ...

Kidney transplant chains more effective in saving lives

August 9, 2018
New research from the UBC Sauder School of the Business has found that transplant societies which prioritize kidney transplant chains over kidney exchanges can increase the total number of transplants, thereby saving more ...

Surgical mesh implants may cause autoimmune disorders

July 31, 2018
Surgical mesh implants, often used for hernia or gynecological repair, may be the reason so many patients report symptoms of an autoimmune disorder, according to a University of Alberta rheumatologist.

Surgeons discuss options when the risks of surgery may be too high

July 27, 2018
In an essay published July 26 in the New England Journal of Medicine, Ira Leeds, M.D., research fellow, and David Efron, M.D., professor of surgery, both of the Johns Hopkins University School of Medicine, along with their ...

Blood plasma during emergency air transport saves lives

July 25, 2018
Two units of plasma given in a medical helicopter on the way to the hospital could increase the odds of survival by 10 percent for traumatically injured patients with severe bleeding, according to the results of a national ...

The dark side of antibiotic ciprofloxacin

July 25, 2018
The use of ciprofloxacin and other antibiotics of the class of fluoroquinolones may be associated with disruption of the normal functions of connective tissue, including tendon rupture, tendonitis and retinal detachment. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.