AdventHealth Porter Performs Rare, Complex Robotic Kidney Cancer Surgery

AdventHealth Porter has reached an extraordinary milestone in surgical innovation, completing what is believed to be the first robotic left radical nephrectomy with inferior vena cava (IVC) thrombectomy in Colorado and possibly the entire Rocky Mountain Region. Fewer than 100 such cases have been published worldwide, making this a remarkable achievement for both the hospital and the patients it will benefit.

The groundbreaking procedure was performed by Dr. Julien Dagenais, urologist with AHMG Urology Denver, who specializes in advanced and complex cancer surgeries.

A Rare and Life-Threatening Diagnosis

The surgery is used to treat renal cell carcinoma, a form of kidney cancer that in rare cases, grows into the veins surrounding the kidney. In fewer than 5% of cases, the cancer extends into the inferior vena cava (IVC) - the largest vein in the body, located next to the spine, responsible for returning blood to the heart.

This is an especially dangerous condition.

“This type of cancer is at risk of blocking blood flow to the heart or extending to the heart itself and causing a pulmonary embolism or even a heart attack,” Dr. Dagenais explained.

It is even more complex when it occurs on the left side, requiring the tumor to grow across the entire left renal vein to reach the IVC.

“That means the dissection has to proceed across the whole body,” he said. “To remove the cancer, the IVC must be opened and the tumor thrombus separated out.”

Traditionally a High-Risk Open Surgery — Now Performed Minimally Invasively

Historically, this surgery required a massive open incision, a large “chevron” cut beneath both rib cages to reach and remove the cancer.
Patients undergoing the traditional approach often face:

• Major blood transfusions
• Several days intubated in the ICU
• A 7–10 day hospital stay
• A mortality risk as high as 10%
• Significant postoperative pain and long recovery

Dr. Dagenais and his surgical team accomplished this with robotic assistance, using small incisions that dramatically reduce trauma and facilitate faster healing.

“The robotic approach allows for small incisions and much easier recovery,” he said. “It can mean less blood loss and fewer complications - in the right hands.”

This surgery requires extraordinary teamwork: a highly skilled bedside assistant, a dedicated anesthesiologist with continuous close monitoring, and a meticulous nursing team capable of responding in real time.

A Win for Patients Across Colorado and the Region

Shortly after surgery, the patient was already walking, talking, and recovering well - a stark contrast to the typical ICU stay required after an open procedure.

For Dr. Dagenais, this milestone represents much more than a technical achievement.

“We’re providing some of the most cutting-edge cancer care available within hundreds of miles,” he said. “It’s part of getting the word out about the magnificent things happening here at Porter. We can help patients in need in Colorado and beyond.”

A Team Effort That Saves Lives

While the condition is serious and complex, Dr. Dagenais emphasizes that outcomes improve dramatically with the right expertise and the right team.

“While this condition is about as serious as it gets, with the right team of medical providers, we can help get patients through it,” he shared.

This surgery underscores AdventHealth Porter’s commitment to bringing advanced, life-saving cancer care to the Rocky Mountain Region - offering hope, healing, and whole-person care to patients facing some of the most challenging diagnoses.

To learn more about the care that Dr. Dagenais provides, please visit: Julien Dagenais, MD | Urology | Denver, CO | AdventHealth