WVU Medicine Urology, WVU Cancer Institute first in state to perform single-port kidney surgery

Surgical system also used for prostate cancer surgery

MORGANTOWN, W.Va. – WVU Medicine Urologic Oncology surgeons at the WVU Cancer Institute recently became the first in the state to perform a single-port partial nephrectomy. The Institute is one of 130 facilities in the United States to implement the single-port robot platform, and only 140 urologists are certified to use this cutting-edge surgical system.  

Ali Hajiran, M.D., WVU Cancer Institute Urologic Oncology chief, demonstrates the single-port procedure.
Ali Hajiran, M.D., WVU Cancer Institute Urologic Oncology chief, demonstrates the single-port procedure.

The new single-port robotic surgical system allows surgeons to insert robot-assisted instruments into the extraperitoneal space, a small, compartmentalized space within the pelvis and back, using only one or two incisions and avoid the abdominal cavity completely. This expands options for patients who are not candidates for open or multiple port procedures due to scarring from prior abdominal surgeries, obesity, or heart or lung conditions. WVU Medicine surgeons are also using the system to perform single port radical prostatectomy procedures for prostate cancer, performing as many as two-to-four surgeries per week.

“Single port procedures are a safe and effective treatment for cancer that can provide patients with a better quality of life,” Ali Hajiran, M.D., WVU Cancer Institute Urologic Oncology chief, said. “We are committed to providing patients with the most advanced and innovative surgical care, and the addition of single port partial and radical nephrectomy and radical prostatectomy to our surgical repertoire is a significant step forward.”

The approach offers several benefits over traditional open and multiple port robotic assisted approaches, including less pain, shorter recovery time, and smaller or fewer scars. 

This means that patients like Luiz Freitas, 72, of Morgantown, can get back to life faster after receiving surgical treatment for cancer.

Freitas and his doctors had been monitoring his prostate and prostate-specific antigens (PSA), a blood test that measures a protein created by the prostate, for two years, when his tests showed a slight increase in PSA. After increasing his follow-up testing to every six months, his PSA levels continued to climb. 

His doctors ordered an MRI, which showed an enlarged prostate. Biopsy results indicated high-risk prostate cancer, and his doctors offered him the options of radiation or surgery. 

“I looked at both options and met with a surgeon and a radiation oncologist to understand the process and the side effects of both,” Freitas said. “Both had the same potential problems of incontinence and impotence. Radiation would have taken six weeks, and I would have had to go to the hospital five days a week and face burns and other side effects. I decided to go with surgery because it seemed like the quicker option.”

While researching his options, he contacted an out-of-state cancer clinic, which reviewed his case and gave him the same options he received at the WVU Cancer Institute. 

“You have to weigh the pros and cons and make a decision based on what you feel,” Freitas said. 

Because Freitas had undergone a minimally invasive abdominal surgery previously, he had scar tissue that increased his risk of complications with a multi-port approach. Dr. Hajiran recommended the less invasive single-port radical prostatectomy to avoid these potential complications.

Freitas credits the single-port approach with his fast recovery and ability to get back to his regular activities sooner.

“I had surgery on a Friday, and I was able to come home the next day,” Freitas said. “On Monday, I was moving around the house and going up and down stairs without any problems. It’s fantastic.”

Now, nearly three weeks after his surgery, Freitas is back to normal activities without any problems. The pathology report after his radical prostatectomy indicated clear margins, and Hajiran said his prognosis is excellent.

“The decision of whether to undergo surgery or radiation is very personal,” Freitas said. “You have to trust the doctor and that the treatment will be effective and the least invasive as possible.”

To date, Hajiran and the surgical oncology team at the WVU Cancer Institute have performed eight single-port radical prostatectomies and one single-port partial or radical nephrectomies since launching the device.

For more information on WVU Medicine Urology, visit WVUMedicine.org/Urology. For more information on the WVU Cancer Institute, visit WVUMedicine.org/Cancer.