Question 1

What is robotic partial nephrectomy?

Accepted Answer

Robotic partial nephrectomy is a minimally invasive kidney-sparing operation that removes the tumor from the kidney while preserving the healthy remainder. It is performed through small keyhole incisions using the da Vinci surgical robot with intraoperative ultrasound to define tumor margins. It is the preferred operation for most kidney masses under 7 cm (T1 tumors).

Question 2

Partial nephrectomy vs. radical nephrectomy — which do I need?

Accepted Answer

Partial nephrectomy removes the tumor and spares the kidney; radical nephrectomy removes the entire kidney. For tumors under 7 cm, partial is preferred because it protects long-term kidney function and lowers cardiovascular and dialysis risk decades out. Radical is chosen when the tumor is large, centrally located around the renal hilum, involves the collecting system extensively, or when partial is technically unsafe. Dr. Tan defaults to partial whenever oncologically and technically feasible.

Question 3

What is the retroperitoneal approach and why does it matter?

Accepted Answer

The retroperitoneal approach enters the kidney from the back rather than through the abdominal cavity. It avoids mobilizing the bowel, is ideal for posterior tumors and patients with prior abdominal surgery, and usually means faster return of bowel function and less postoperative pain. Dr. Tan chooses between retroperitoneal and transperitoneal approaches based on tumor location, patient anatomy, and surgical history.

Question 4

What is caval thrombectomy?

Accepted Answer

Some kidney cancers grow into the renal vein and up the inferior vena cava (IVC) as a tumor thrombus. Caval thrombectomy removes the kidney and the tumor thrombus from the vein. Robotic caval thrombectomy is one of the most complex urologic operations; Dr. Tan performs it at NYU Langone for selected level I–III IVC thrombi, with multidisciplinary vascular and cardiac surgery support available for higher levels.

Question 5

What is Signatera MRD testing?

Accepted Answer

Signatera is a personalized blood test that detects tumor-specific circulating DNA (ctDNA) after surgery. A negative test is reassuring; a positive test often flags recurrence months before it is visible on imaging. Dr. Tan uses Signatera after nephrectomy for higher-risk pathology to personalize surveillance and guide decisions about adjuvant therapy.

Question 6

How long is the recovery after robotic nephrectomy?

Accepted Answer

Most patients stay in the hospital 1–2 nights. Normal daily activity resumes within 2 weeks; lifting restrictions lift at 4–6 weeks. Return to full work typically takes 3–4 weeks for desk work, 6 weeks for physically demanding jobs. The minimally invasive approach means less pain and a faster recovery than open surgery.

Question 7

Will I need dialysis after partial nephrectomy?

Accepted Answer

No — that is the entire point of partial nephrectomy. By sparing healthy kidney tissue, partial nephrectomy preserves long-term renal function and keeps most patients far from any dialysis threshold. Even after radical nephrectomy, a single healthy kidney compensates and dialysis is not needed in the vast majority of cases.

Question 8

How do you follow up after kidney cancer surgery?

Accepted Answer

Surveillance is risk-based. For low-stage tumors: imaging (CT or MRI) and labs every 6–12 months, spacing out at 5 years. For higher-stage or high-grade tumors: more frequent imaging and chest CT, plus Signatera ctDNA testing when indicated. Dr. Tan personalizes the schedule based on final pathology.

Robotic Kidney Surgery — Partial & Radical Nephrectomy

Partial Nephrectomy

Radical Nephrectomy & Caval Thrombectomy

Signatera MRD Testing

Personalized Recurrence Monitoring

Why Kidney-Sparing Matters

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