Light giving physicians edge in kidney surgery

Lighting up the kidney is giving physicians an “edge” when removing tumors, while preserving the rest of the kidney.

Thanks to a new technology called “Firefly,” urologists at Advocate Christ Medical Center in Oak Lawn, Illinois, are able to remove kidney cancer with improved precision. Firefly is an image-guided system that uses near-infrared wavelengths of light to cause normal kidney tissue to glow green, while keeping kidney tumors relatively dark, when injected with a special dye. The technology helps surgeons clamp off select arteries feeding the kidney and readily identifying the contours and edges of the tumor.

“The kidney tumor typically does not take up the dye; it remains dark,” says Dr. Aaron Berger, a urologist at Christ Medical Center.

As they work to remove the kidney, the surgeons toggle between white and near-infrared light. “Once we see green on all sides of the area where the tumor was located, we know that we have reached normal tissue and that all of the abnormal mass has been removed,” Dr. Berger explains.

Because the Firefly precisely maps out the tumor, physicians do not have to cut too deeply into normal tissue to ensure all the tumor has been eliminated. The intent is to preserve as much of the kidney as possible and help it return to normal function, Dr. Berger says.

The new Firefly system works in consort with the da Vinci robot – technology that allows physicians to perform operations minimally invasively, yet precisely. “With the robot, we need to make only three or four fingernail-size incisions to perform kidney surgery,” Dr. Berger says.

Firefly is used in combination with a surgeon’s direct vision of the tumor and ultrasound to ensure that all of the cancer is removed, while preserving as much kidney as possible.

More than 50 kidney cancer surgeries have been performed robotically at Christ Medical Center. About half of those cases have been done successfully using Firefly, Dr. Berger said.

The National Cancer Institute estimates new cases of kidney cancer in the United States in 2014 will total nearly 64,000. Approximately 1.6 percent of men and women will be diagnosed with kidney cancer and renal pelvis cancer at some point in their lifetime. Age, obesity, history of smoking and high blood pressure are suspected factors in increasing a person’s risk for developing kidney cancer, experts warn.

Many kidney cancers are discovered accidentally when a person undergoes abdominal imaging either because of injury or another, unrelated health issue, Dr. Berger says.