Robotic Kidney and Reconstructive Surgery

At Mount Sinai Urology, our experience with robotic kidney cancer and reconstructive surgery is extensive. Our robotic partial nephrectomy approach allows for a precise excision of the tumor while leaving the healthy and functional part of the kidney intact. In addition, minimally invasive robotic surgery offers fewer complications and side effects, smaller incisions, less scarring, decreased post-surgical pain, shorter hospital stays, and faster recovery.

F.A.S.T. Robotic Partial Nephrectomy

F.A.S.T. robotic partial nephrectomy is an advanced approach to surgically remove a kidney tumor and reconstruct the kidney to prevent functional damage. Developed by Ketan K. Badani, MD, Director of the Comprehensive Kidney Cancer Program, this procedure enables the surgeon to minimize the damage to the normal part of the kidney by precisely removing the tumor along using real time ultrasound mapping, and minimizing time the kidney is without bloodflow during this critical portion of a partial nephrectomy.  This is known as ischemia time, and by reducing this number, we also lower the changes of kidney loss over a patient's lifetime.  This approach also allows us to more safely and reliably perform partial nephrectomy (compared to removing the entire kidney) in even the most complex tumor sizes and locations while still offering the best outcome possible for the patient.

Dr. Badani originally developed F.A.S.T. as a means to shorten partial nephrectomy ischemia time. This is a critical point when the kidney is without blood flow while the tumor is being excised and the kidney reconstructed. Historically robotic surgeries involved the surgeon plus any number of assistants who are called on to carry out important portions of the operation. In a F.A.S.T. robotic partial nephrectomy, we never leave the controls. Dr. Badani's technique takes certain steps out of the hands of the assistant, and puts them back into the hands of the robotic surgeon. That shaves minutes off the procedure and reduces the amount of time in which blood flow to the kidney is stopped (ischemia time). If you have kidney cancer, that's better for your kidney, and better for you.

The F.A.S.T. technique also allows Dr. Badani to perform robotic partial nephrectomies on increasing numbers of complex kidney tumors rather than having to remove the entire kidney. It is typical for surgeons to remove the entire kidney if the tumor is large, or close to key structures in the kidney. The F.A.S.T. approach allows us to safely and effectively save kidneys, even in complex circumstances.


The benefits of F.A.S.T. include:

  • Using small “keyhole” incisions instead of a major incision results in less blood loss and faster recovery
  • Decreased ischemia (by as much as 50 percent) and operative time lowers the chances of poor outcomes
  • Enhanced visualization and tumor identification allows us to see both the operative field and ultrasound images simultaneously
  • Immunofluorescence imaging enables us to focus on the specific branch that feeds the tumor, clamp it, and maintain blood flow to the rest of the kidney. This decreases, or even eliminates, ischemia time in many cases