The gold standard for kidney cancer surgery. Precise, keyhole, kidney
preserving — guided by a Mayo Clinic–trained specialist who does this every
week.
High
Volume
ROBOTIC SURGEON
1–2 days
95%+
KIDNEY FUNCTION PRESERVED
<200 ml
HOSPITAL STAY
Da Vinci Robotic System
Mayo Clinic Trained
AVG. BLOOD LOSS
Kidney-Preserving Surgery
4–5 Keyhole Incisions <20 min Warm Ischaemia
ROBOTIC PARTIAL NEPHRECTOMY
NEPHRON-SPARING SURGERY
KIDNEY CANCER
DR. ROHIT DADHWAL
FORTIS HOSPITAL MOHALI
RD
Dr. Rohit Dadhwal
MS (SURGERY) · MCH (UROLOGY) · URO-ONCOLOGIST TRAINED AT MAYO CLINIC,
USA · ROBOTIC SURGERY SPECIALIST · FORTIS HOSPITAL MOHALI
Dr. Rohit Dadhwal is a Consultant Urologist and Robotic Surgeon at Fortis Hospital
Mohali, with advanced Uro-Oncology training from the Mayo Clinic, USA. He is one
of Punjab’s most experienced robotic kidney cancer surgeons, specialising in
robotic partial nephrectomy — the most technically demanding, kidney-preserving
approach to treating renal tumours. As a high-volume robotic surgeon, his practice
is guided by AUA and EAU guidelines, ensuring every patient receives care
benchmarked to global standards.
Fortis Hospital Mohali
Da Vinci Robotic System
Uro-Oncologist · Mayo Clinic USA
MCh Urology AUA / EAU Guidelines
THE PROCEDURE
What Is Robotic Partial Nephrectomy?
Robotic partial nephrectomy — also called nephron-sparing surgery — is a
minimally invasive surgical procedure to remove a kidney tumour while leaving
the healthy part of the kidney completely intact and functioning. It is the
recommended standard of care for kidney tumours up to 7 cm, endorsed by
the American Urological Association (AUA) and European Association of
Urology (EAU).
Precision Surgery
rough Five Keyhole Incisions
Using the da Vinci robotic system, Dr. Dadhwal operates through just
4–5 incisions — each smaller than 1 cm — guided by a 10× magnified,
three-dimensional view of the kidney. Robotic instruments replicate
the surgeon’s hand movements with tremor filtration and micro
precision, reaching anatomical planes impossible with the naked eye
or standard laparoscopy.
The kidney’s blood supply is temporarily clamped, the tumour is
excised with a clear margin of normal tissue, and the kidney is then
meticulously reconstructed with sutures — all in under 20 minutes.
The rest of the kidney is completely una ected and continues to
function normally.
The result: cancer removed completely. Kidney preserved. Patient
home in 24–48 hours.
“When I operate robotically, I can see structures in the
kidney that are simply invisible to the naked eye.
at
magnification, combined with tremor-free precision, is
what makes it possible to remove a tumour cleanly while
keeping the healthy kidney perfectly intact.”
— DR. ROHIT DADHWAL · URO-ONCOLOGIST · MAYO CLINIC TRAINED
HOW IT WORKS
e
ree Pillars of Robotic Partial
Nephrectomy
1
3D Magni!ed Vision
The da Vinci robotic camera provides 10× three-dimensional magnification of
the kidney, tumour, and surrounding blood vessels and collecting system. This
level of detail — far beyond what the human eye can see — is what enables Dr.
Dadhwal to identify the precise tumour boundary, protect adjacent structures,
and excise cancer with clear margins every time.
2
Tremor-Free Micro-Precision
The robotic system filters out the natural tremor present in every surgeon’s
hands and scales movements down to a fraction of their size. This transforms
broad hand gestures into micro-precise instrument movements inside the body
— allowing delicate dissection, controlled vessel management, and
reconstruction of the kidney with sutures in an extremely confined space.
3
Rapid Kidney Reconstruction
Once the tumour is removed, the kidney must be reconstructed — the defect
closed in layers — before the blood clamp is released. Speed and precision here
directly determine how much kidney function is preserved. Robotic dexterity
consistently enables reconstruction in under 20 minutes of warm ischaemia, the
critical threshold for protecting long-term kidney health.
WHY ROBOTIC SURGERY
6 Reasons Robotic Partial Nephrectomy Is
the Best Choice
Your Kidney Is Preserved — For Life
This is the defining benefit. Instead of removing the entire kidney, only the
tumour and a small margin of normal tissue are excised. The remaining kidney
continues to work normally. This preservation significantly reduces your lifetime
risk of chronic kidney disease, high blood pressure, cardiovascular disease, and
dialysis — benefits that compound over decades.
95%+
KIDNEY FUNCTION MAINTAINED AFTER SURGERY
Complete Cancer Removal — Clear Margins
The robotic system’s 10× 3D view allows Dr. Dadhwal to see exactly where
normal tissue ends and tumour begins — even for complex, centrally located
tumours. This precision consistently achieves negative surgical margins,
predictor of long-term cure.

95%
meaning no cancer cells are left behind. Clear margins are the strongest
NEGATIVE SURGICAL MARGIN RATE
Tiny Incisions — No Muscle Cutting
Open kidney surgery requires a 20–25 cm flank incision often cu ing through
major back and abdominal muscles — causing severe pain, slow healing, and
risk of chronic discomfort. Robotic surgery uses just 4–5 incisions under 1 cm.
Patients experience far less pain, are mobile the same day, and return home
with minimal scarring.
4–5
INCISIONS, EACH UNDER 1 CM
Minimal Blood Loss — No Transfusion Needed
The kidney has one of the richest blood supplies in the body. Open surgery
traditionally involved significant bleeding. Robotic precision — with targeted
cauterisation and controlled dissection under magnification — dramatically
not need a blood transfusion.
<200 ml
reduces intraoperative blood loss. The overwhelming majority of patients do
AVERAGE BLOOD LOSS — TRANSFUSION RATE <2%
Short Warm Ischaemia — Kidney Protected
During surgery, the kidney’s blood supply is temporarily clamped — this is warm
During surgery, the kidney’s blood supply is temporarily clamped — this is warm
ischaemia. Every minute counts: prolonged ischaemia damages nephrons
permanently. Robotic precision enables tumour excision and kidney
reconstruction consistently under 20 minutes, well within the safe threshold —
protecting long-term kidney function.
<20 min
WARM ISCHAEMIA TIME — CONSISTENTLY ACHIEVED
Home in 24–48 Hours — Back to Life in Weeks
Open partial nephrectomy meant 5–7 days in hospital and 8–12 weeks of
recovery. With robotic surgery, most patients go home in 1–2 days, return to
24–48 hrs
light work in 2–3 weeks, and resume full normal activity within 4–6 weeks.
Faster recovery means less disruption to your life, your family, and your work.
HOSPITAL STAY — 4–6 WEEKS FULL RECOVERY
“Removing an entire kidney when only a small part of it has a tumour is
unnecessary and harmful. Robotic partial nephrectomy gives equivalent
cancer control — and every study confirms it protects kidney function,
cardiovascular health, and quality of life long-term. It is the right operation
for the right patient, done with precision.” — Dr. Rohit Dadhwal
SIDE-BY-SIDE
Robotic Partial vs. Open Surgery vs.
Removing the Whole Kidney
AUA and EAU guidelines recommend robotic partial nephrectomy as the standard
of care for T1 kidney tumours whenever technically feasible. Here is why:
FACTOR
ROBOTIC
PARTIAL
NEPHRECTOMY
OPEN
PARTIAL
NEPHRECTOMY
RADICAL
(FULL)
NEPHRECTOMY
Kidney
Preserved?
✓✓✓✓ Yes — fully
preserved
◑ Yes — harder
technically
✗ No — entire
kidney removed
Hospital
Stay 24–48 hours 4–6 days 3–5 days
Incision
Size
4–5 cuts <1 cm
each
15–25 cm open
wound 12–20 cm incision
Blood Loss <200 ml 400–800 ml 200–500 ml
Blood
Transfusion Rarely (<2%) Sometimes (10
20%) Sometimes
Post-op
Pain
Mild — oral
medication
Significant — IV
opioids
Moderate
Return to
Normal
Life
3–4 weeks 8–12 weeks 6–8 weeks
Warm
Ischaemia
Time
<20 min
(consistently)
Variable — often
longer Not applicable
Risk of
CKD /
Dialysis
Very low Low Higher — one
kidney lost
Cancer
Control (T1)
✓✓✓✓ Equivalent to
radical ✓ Equivalent ✓ Standard —
but overkill for T1
3D
Magnified
Vision
✓✓✓✓ 10×
magnification ✗ Naked eye only ◑ Laparoscopic
option only
YOUR JOURNEY
What to Expect — Before, During & A er
Surgery
1
2
CONSULTATION
Expert Assessment & Surgical Planning
Dr. Dadhwal reviews your CT/MRI scans in detail, assesses the
tumour’s size, location, complexity (RENAL nephrometry score),
and your kidney function (eGFR). A personalised plan is created
— including whether robotic partial nephrectomy is feasible,
whether nerve-sparing or vascular reconstruction is needed,
and what outcomes you can realistically expect. All your
questions are answered with complete transparency.
PRE-OPERATIVE
Workup & Preparation
Blood tests, renal function panel, chest X-ray, ECG, and pre
anaesthesia assessment are arranged. Blood thinners and
no surprises.
certain medications are adjusted. You receive clear instructions
on fasting, bowel prep, and what to bring on the day. By the
time you arrive for surgery, everything is planned and there are
3
4
DAY OF SURGERY
Robotic Partial Nephrectomy (2–3 Hours)
Under general anaesthesia, 4–5 keyhole incisions are made. The
da Vinci robotic system is positioned and Dr. Dadhwal operates
from the console with 10× 3D vision. The kidney’s blood supply is
clamped, the tumour is precisely excised with a clear tissue
margin, and the kidney is reconstructed in layers with sutures —
consistently under 20 minutes warm ischaemia. Blood loss is
minimal. The tumour specimen is sent for histopathology. You
are in recovery within hours.
DAY 1–2
Early Recovery & Discharge
Most patients are si ing up, taking fluids, and walking within a
few hours of surgery. Pain is mild and well controlled with oral
medications. The urinary catheter is removed within 24 hours in
most cases. Diet resumes the same evening. The vast majority
of patients are fit for discharge on Day 1 or Day 2 with wri en
instructions and a follow-up plan.
5
6
WEEK 2–6
Recovery at Home
Light walking from Day 3 onwards. Driving permi ed at 2–3
weeks. Light desk work typically resumable at 2–3 weeks.
Strenuous activity and lifting held until 6 weeks. A wound check
and kidney function blood test (eGFR, creatinine) are done at 2
weeks to confirm recovery is on track.
LONG-TERM
Surveillance & Kidney Function Monitoring
Histopathology confirms tumour type, grade, and margin
status. CT or MRI surveillance follows at 6 months, 12 months,
function.
then annually — per AUA guidelines for the specific tumour type.
eGFR is monitored at each visit to confirm kidney function is
stable. Most T1 RCC patients treated with robotic partial
nephrectomy achieve long-term cure with excellent kidney
COMMON QUESTIONS
Frequently Asked Questions
Why not just remove the whole kidney to be safe?
1
This is the most common concern patients bring. The evidence is clear:
removing an entire kidney for a tumour confined to part of it is unnecessary
and increases long-term harm. The AUA and EAU both recommend partial
nephrectomy as standard of care for T1 tumours (<7 cm). Cancer control is
equivalent to radical nephrectomy, while preserving kidney function reduces
lifetime risk of CKD, dialysis, and cardiovascular events. You are not being
undertreated — you are being treated optimally.
2
Will my kidney work normally a er partial nephrectomy?
In the vast majority of cases, yes. Robotic partial nephrectomy consistently
preserves over 90–95% of pre-operative kidney function, especially when
warm ischaemia time is kept under 20–25 minutes — something Dr. Dadhwal
achieves routinely. Kidney function (eGFR) is checked at follow-up visits. For
patients with diabetes, hypertension, or pre-existing kidney disease, preserving
every functioning nephron is critical — making partial nephrectomy even more
essential in these groups.
3
Is robotic surgery safe for large or complex tumours?
Yes — in experienced hands. Complex tumours close to the kidney’s blood
vessels, renal hilum, or collecting system are precisely where robotic
magnification and precision provide the greatest advantage over open
surgery. Dr. Dadhwal regularly operates on high-complexity renal tumours
(high RENAL nephrometry scores) robotically, including tumours previously
considered suitable only for open surgery. The conversion-to-open rate in
high-volume robotic centres is very low.
4
Will the cancer come back a er robotic partial nephrectomy?
For localised T1 renal cell carcinoma treated with clear margins, local
recurrence rates are very low — 5-year recurrence-free survival exceeds 90%
in published series. Regular CT/MRI surveillance per AUA guidelines is
important to detect any rare local recurrence or distant metastasis early, when
treatment is most e ective. The histopathology report after surgery confirms
tumour grade and type, guiding the surveillance schedule.
5
How long will I be in hospital and when can I go back to work?
Most patients are discharged in 24–48 hours after robotic partial
nephrectomy. Light desk work is typically possible within 2–3 weeks. Driving
resumes at 2–3 weeks once you’re comfortable and o strong pain medication.
Physically demanding work or heavy lifting is held until 6 weeks. Dr. Dadhwal
provides a tailored return-to-activity plan based on your recovery progress,
occupation, and any complications.
6
Is world-class robotic kidney surgery available in Mohali?
Absolutely — you do not need to travel to Delhi, Mumbai, or abroad. Fortis
Hospital Mohali houses the da Vinci Robotic Surgical System, a dedicated Uro
Oncology programme, and international-standard peri-operative care. Dr.
Dadhwal trained at the Mayo Clinic USA and brings that expertise directly to
Mohali. Patients from across Punjab, Himachal Pradesh, Haryana, and Jammu
& Kashmir regularly receive robotic kidney cancer surgery here at outcomes
equivalent to the best centres globally.
WHY VOLUME MATTERS
Why a High-Volume Robotic Surgeon
Changes Your Outcome
Robotic partial nephrectomy is widely regarded as the most technically
demanding procedure in urological surgery. Published evidence confirms that
complication rates, warm ischaemia time, margin status, and kidney function
preservation are all directly tied to surgeon experience.
3×
Lower Complication Rate
High-volume robotic surgeons have significantly lower rates of intraoperative
bleeding, urinary fistula, and conversion to open surgery — complications that
rise sharply in low-volume centres, regardless of patient complexity.
<20 min
Consistent Warm Ischaemia
Keeping warm ischaemia under 20–25 minutes is the most important technical
factor for preserving kidney function. This consistency only comes from
performing high volumes of robotic partial nephrectomies — not occasional
cases.
Mayo
Clinic
International Training Standard
Dr. Dadhwal’s Uro-Oncology training at the Mayo Clinic USA — one of the
world’s premier cancer centres — means his technique, decision-making, and
outcomes are benchmarked to global best practice, not regional norms.
1
The Question to Ask Every Surgeon
Before agreeing to kidney cancer surgery, ask: “How many robotic partial
nephrectomies do you perform per year, and what is your warm ischaemia
time and margin rate?” A skilled, confident surgeon answers with data.
A Kidney Tumour Found Early Is a Kidney
Cancer Cured.
If you or a loved one has been found to have a kidney mass, don’t wait. Get a
specialist opinion from a high-volume robotic surgeon. Dr. Rohit Dadhwal
o ers thorough, evidence-based consultations at Fortis Hospital Mohali —
where you’ll get clear answers, honest advice, and world-class robotic
surgical care.
Book an Appointment Visit Fortis Mohali
Dr. Rohit Dadhwal
MS · MCh (Urology) · Uro-Oncologist · Mayo Clinic Trained · Robotic Surgeon · Fortis Hospital
Mohali
Fortis Hospital, Phase 8, Mohali, Punjab Fortis Helpline
Mon–Sat: 9 AM – 5 PM
This blog is for patient education only and does not constitute medical advice. Clinical decisions must be made in
consultation with a qualified specialist following appropriate evaluation. Statistics are based on peer-reviewed
published literature and high-volume centre data. AUA: American Urological Association. EAU: Europea