Surgeon demonstrates procedure, saves Bradenton patient’s kidney

twolfrum@bradenton.comMarch 12, 2010 

SARASOTA — A surgeon at Sarasota Memorial Hospital saved a Bradenton man’s kidney Thursday while demonstrating a procedure that could change the way renal cancer is treated across the country.

Dr. Robert I. Carey performed a laparoscopic radiofrequency ablation of a kidney tumor on patient Bob Saunders, an 83-year-old retiree.

While Carey has successfully completed the procedure he helped innovate more than 100 times in the past eight years, Thursday’s surgery was different.

It drew a crowd.

Thousands of Carey’s colleagues watched from the Southeastern Section of the American Urological Association’s annual meeting in Miami as Carey and partner Dr. Daniel Kaplon performed the surgery in Sarasota on a live Web cast.

“When I talked to the patient, he asked me, ‘What are the complication rates?’ I told him, ‘They’re very low when no one’s watching. When you have several thousand people watching you, I don’t know what the complication rates are,’ ” Carey said.

Fortunately, the bright lights didn’t bother Carey. Thursday’s procedure was a success.

The surgery took less than an hour, after which Carey took questions from colleagues at the conference.

Saunders is scheduled to leave the hospital today, his 84th birthday.

Doctors told Saunders 18 months ago about a growth on his kidney, according to his daughter, Diane Pappas. He discussed other procedures that would have cost him his kidney before a friend told him about Dr. Carey, she said.

“We were kind of scared about him having major surgery at his age,” Pappas said. “But we didn’t like the idea of doing nothing. ... The fact he could keep his kidney was something he was elated about.”

Saunders, a father of four, moved to Bradenton about 20 years ago from Reading, Mass., Pappas said. The retired postal worker grew restless after moving here and got a job delivering advertising inserts for the Bradenton Herald.

He left that job about three years ago, but remains active, riding his bicycle and doing yard work, Pappas said.

Pappas said her father was happy to have his surgery shown to urologists.

“They asked for his permission, and he said, ‘Sure, if it will help someone else, go right ahead,’ ” she said.

Carey melted a 3.3-centimeter tumor from one of Saunders’ kidneys using small incisions and scopes through which a small camera and instruments were placed into the body.

Radiofrequency ablation uses heat energy to destroy the cancerous tissue where it exists without compromising kidney function.

The minimally invasive procedure differs from traditional treatment of renal cancer, which affects about 40,000 people in the United States every year.

Because renal cancer does not respond well to chemotherapy or radiation, most surgeons opt for removal of the affected kidney and nearby lymph nodes, Carey said.

“Too often when patients have kidney cancer, we remove the entire kidney. When we remove the entire kidney, that leaves someone with just one kidney, and their risk of dialysis goes up,” Carey said.

Carey faced a minor complication Thursday because Saunders is on the blood thinner Coumadin. About 20 percent of the body’s blood circulates through the kidneys every minute, Carey said, meaning one wrong move could have been fatal to Saunders.

“I had everything set up very well so that as we were operating and teaching, we were able to go step by step,” Carey said. “The way I look at it is we try to use overwhelming force to make sure that every possible complication or problem can be seen ahead of time.”

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