Tuesday, December 29, 2009

More on surgical options from my doctor

Last May my urologist/surgeon, Dr. Andrew Wagner, graciously did an informal interview with me about surgical options for kidney cancer. That post is here.

People on my kidney cancer patient community on ACOR.org were recently discussing the different ways their surgery was done. I asked Dr. Wagner for his thoughts about "open" surgery vs laparoscopy (I had the latter), and he responded:

There are several options for open nephrectomy, some incisions removing portions of rib and some not.

All of the open options ("back or front or side or flank etc.") are generally decided on based on surgeon preference and training. For example I have a "go to" incision for open nephrectomy called a thoracoabdominal incision, it is a flank incision but extended to also open the diaphragm. This is a fairly common urologic incision for open kidney surgery.

I need to remove a piece of rib about half the time with this incision. I like this (rather large) incision because the only time I do open kidney surgery is if the tumor is very large or if the patient has had major abdominal or flank surgery already. In my opinion and experience, over 90% of kidney tumors should be able to be completed laparoscopically.
(reprinted with permission)

My hospital's renal tumor program web site, with contact info for the doctors, is at www.bidmc.org/renaltumor.


  1. Hi Dave;

    Off topic and Paul probably already sent this to you, but I thought you'd like to see a mention of you in the Health Leaders Media newsletter:


    Maybe you can use it as a lever for more consultant business! (: I also enjoyed the article for its admonition to docs that practices cannot remain the same...
    take care;

    nonlocal MD

  2. Oo, what fun! Thank you, nonlocal!

    In case you ever decide to come out of hiding, keep an eye on my schedule.

  3. Ah,too bad; you will be in my area the next couple months but I am stuck in Florida! (and I do mean stuck; not by choice...)
    I only remain blog-anonymous so I can tell stories from my experience without implicating the guilty; Paul is free to give you my ID and email address should you ever need it. Happy New Year!




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