FV surgeons use robotic surgery to remove a 7cm tumour while preserving a female patient’s kidney

With the assistance of the da Vinci Xi robotic system, the FV Hospital surgical team successfully removed the entire 7cm tumour from the upper pole of the patient’s right kidney without removing the kidney.

Large kidney tumour detected during a routine health check

Nguyen Thi Lien, 56, from Quang Ngai, discovered a tumour in her right kidney during a routine health check. Prior to this, she had experienced no unusual symptoms.

At the initial healthcare facility, she was advised to undergo a radical nephrectomy, which would have left her with only one kidney and potentially affected her long-term kidney function.

Referred by an acquaintance, she sought treatment at FV Hospital. Dr Pham Duc Minh, MSc, Specialist Level I – FV da Vinci Robotic Surgery Centre, conducted clinical assessments and an MRI scan to reassess her condition. The results revealed a tumour measuring approximately 7cm at its widest point, located at the upper pole of the right kidney and compressing the adrenal gland. Fortunately, the tumour remained confined to the kidney and had not invaded the liver.

Following a comprehensive assessment, Dr Minh concluded that removal of the entire kidney was unnecessary. Instead, he proposed removing the tumour while resecting only approximately 30% of the kidney.

According to Dr Minh, the tumour’s location at the upper pole of the kidney, its considerable size and its proximity to the adrenal gland meant that the surgical field contained several important structures that needed to be protected. In this situation, robotic surgery offers advantages in accessing and performing precise movements within a confined space, helping the surgeon remove the tumour while minimising damage to healthy tissue and surrounding organs.

Importantly, the goal of the operation was not only to remove the entire tumour but also to preserve as much of the remaining kidney as possible, while ensuring oncological safety.

After the doctor had thoroughly explained her condition and the proposed treatment approach, Ms Lien and her family decided to proceed with da Vinci Xi robotic surgery, hoping for a swift recovery and, most importantly, to preserve as much of her kidney as possible.

The patient poses for a commemorative photo with Dr Pham Duc Minh, MSc, Specialist Level I before discharge.

Robotic surgery removes entire tumour in a challenging location, preserving nearly 70% of the kidney

According to Dr Minh, this was a particularly complex operation. The tumour was large and located at the upper pole of the kidney, making kidney-preserving surgery more challenging. The surgeon had to mobilise the kidney more extensively than usual to bring it down and facilitate access to the tumour. As the tumour was in the right kidney, the liver also had to be lifted to gain access to the surgical site.

Another significant challenge was the tumour’s proximity to the adrenal gland, an endocrine organ that plays an important role in regulating blood pressure. Even unintended manipulation of this area could cause serious fluctuations in blood pressure during surgery.

Therefore, the surgical team’s challenge was not simply to remove the entire tumour, but also to protect surrounding vital structures, control bleeding and preserve as much healthy kidney tissue as possible.

In addition, the renal artery had to be temporarily clamped during surgery to stop the blood supply to the kidney, providing a bloodless surgical field and allowing the tumour to be removed with controlled bleeding. The shorter the clamping time, the better the prospects for preserving kidney function. According to the recommendations applied in this operation, this period needed to be kept under 20 minutes.

During Ms Lien’s operation, Dr Pham Duc Minh, MSc, Specialist Level I, controlled the da Vinci Xi robotic system to access the kidney through the abdomen via four small incisions, each approximately 8mm. The robotic arms were inserted into the body to dissect and remove the tumour, together with a thin margin of surrounding kidney tissue measuring approximately 5mm, to ensure oncological safety.

Within the narrow and deep surgical field, the robotic arms offered exceptional manoeuvrability, enabling the surgeon to perform delicate dissection with precision while minimising the risk of injury to surrounding organs.

Robotic surgery using the da Vinci Xi system for kidney cancer.

The operation was completed approximately three hours after the patient was placed under general anaesthesia. The entire tumour was successfully removed without the need to remove the whole kidney. Thanks to the surgical team’s seamless coordination and the precision of the robotic system, the renal artery clamping time was just 18 minutes.

Five days after surgery, Ms Lien was discharged from hospital, having made an almost complete recovery. Post-operative test results showed that her kidney function was virtually normal. She expressed her gratitude at having the tumour treated while preserving her kidney: “Dr Minh explained everything very thoroughly and made sure we understood the situation clearly. I would also like to thank the hospital team for their attentive and dedicated care throughout my stay.”

According to Dr Minh, removing a kidney tumour that compresses the adrenal gland is a technically demanding procedure, particularly when the tumour is large and located in a complex position. Such cases require close coordination between different specialties to maintain stable blood pressure, ensure complete tumour removal and minimise damage to healthy tissue. Robotic surgery helps make the procedure safer, faster and more effective.

Dr Pham Duc Minh, MSc, Specialist Level I, has nearly seven years of experience in robotic surgery and has participated in hundreds of procedures using the da Vinci robotic system. He currently works as a collaborating surgeon at the FV da Vinci Robotic Surgery Centre, FV Hospital.

Dr Pham Duc Minh, MSc, Specialist Level I – da Vinci Xi robotic surgery specialist in Urology.

For more information about kidney cancer surgery using the da Vinci Xi robotic system at FV Hospital, please visit 06 Nguyen Luong Bang Street, Tan My Ward (formerly District 7), Ho Chi Minh City, or call (028) 3511 3333.