Andrew Kennedy Smith

I am a urologist based in Wellington, New Zealand, with clinical responsibilities at Wellington Public Hospital and Riddiford Medical Specialists. Additionally, I serve as a Senior Lecturer at Otago Medical School. I founded and currently direct Riddiford Medical Specialists. My practice encompasses general urology, with specialized interests in Uro-Oncology, Transplantation, GU Reconstruction, and Female Urology. I have a particular focus on minimally invasive kidney surgery, having developed a technique for partial nephrectomy using waterjet dissection. I am honored to have been a faculty member at numerous international scientific meetings and have participated in several workshops and surgical demonstrations of this technique.

15th August 2025

Time Session
15:30
17:00
  • Siros JitpraphaiThailand Speaker RCC and IVC ThrombectomyRCC and IVC thrombus Siros Jitpraphai Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, THAILAND Abstract Renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombus represents a complex surgical challenge, with an incidence of venous involvement in 4-10% of cases. This case report demonstrates the successful surgical management of a 58-year-old female patient with a large left-sided renal mass and IVC thrombus. The patient presented with gross hematuria and was diagnosed with a 10 cm clear cell renal cell carcinoma (Fuhrman nuclear grade 3) extending into the renal vein and IVC. Recognizing the complexity of the case, a multidisciplinary approach was employed, involving urological and hepatobiliary surgical teams. The comprehensive treatment strategy included an open radical nephrectomy with IVC thrombectomy. The surgical technique was meticulously planned and executed, with several key considerations. Preoperative imaging was crucial in determining the exact level of thrombus, allowing for precise surgical planning. The procedure emphasized careful vascular control and en-bloc tumor removal, with intraoperative ultrasound used to ensure accurate thrombus localization. Surgical teams worked collaboratively to minimize potential complications and maximize surgical success. Operatively, the procedure was substantial, with an estimated blood loss of 900 mL and a total operative time of 5 hours. The patient required two days of postoperative intensive care and was discharged from the hospital seven days after the surgery. Pathological examination confirmed the diagnosis of clear cell renal cell carcinoma, with no lymph node metastasis detected and positive tumor thrombus. Importantly, surgical margins were found to be free of tumor. Follow-up evaluations have been encouraging, with no signs of tumor recurrence observed during regular intervals. This case illustrates the critical importance of a systematic surgical approach, precise technical execution, and comprehensive multidisciplinary management in successfully treating RCC with IVC thrombus. It provides valuable insights into the complex surgical management of this challenging condition, potentially offering guidance for similar cases in the future. Keyword: RCC (Renal Cell Carcinoma), IVC Thrombus, Thrombectomy, Surgical Technique, Multidisciplinary Management Highlight: RCC with IVC thrombus is a complex surgical challenge affecting 4-10% of cases. Successful management requires meticulous preoperative imaging, multidisciplinary team approach, and precise surgical technique. With careful planning and execution, 45-70% of patients can be cured through radical nephrectomy and IVC thrombectomy. Robotic Partial Nephrectomy in Complex and Difficult Tumor Location
  • Surya Prakash VaddiIndia Speaker Cytoreductive Nephrectomy in the Era of Immune TherapyRobotic Partial Nephrectomy in Tumors with High Renal Score
  • John YuenSingapore Moderator Technical Pearls: Total Extraperitoneal TechniquePractice-Changing Development in RaLRP
    Andrew Kennedy SmithNew Zealand Speaker Zero Ischemia Laparoscopic Partial NephrectomyNephron preservation with complete tumour excision and without complications remain the goals of surgery for early-stage kidney tumours. This surgery remains technically challenging using a minimally invasive platform, and there remain variations of technique. We present what is now an established approach within our centre, but has been enhanced by progressive improvements in the specific surgical instrumentation. The technique is achievable in a smaller centre with lower surgical volumes. We perform a laparoscopic partial nephrectomy using waterjet and advanced bipolar energy without vascular clamping and without renorrhaphy, supplemented with topical hemostatic agents, reliably achieving the stated goals of this surgery. Ischaemia and delayed complications are minimised by avoiding renorrhaphy and vascular clamping during dissection.Zero Ischemia Laparoscopic Partial Nephrectomy for Hilar TumorsOur technique for hilar tumours remains similar to that for peripheral tumours, again using waterjet and advanced bipolar energy without vascular clamping and without renorrhaphy, supplemented with topical hemostatic agents. Waterjet may be safely used directly on major vessels and collecting system structures, and directly on the tumour capsule, to perform either conventional partial nephrectomy with parenchymal margin or tumour enucleation. With hilar dissection, it is possible to visualise and control arterial supply directly to the tumour, reducing the potential for blood loss. The stated goals of this surgery are achieved. The technique which avoids renorrhaphy is particularly relevant in hilar tumours where renorrhaphy may not be technically achievable.
  • Takashi SaikaJapan Moderator
    Andrew Kennedy SmithNew Zealand Speaker Zero Ischemia Laparoscopic Partial NephrectomyNephron preservation with complete tumour excision and without complications remain the goals of surgery for early-stage kidney tumours. This surgery remains technically challenging using a minimally invasive platform, and there remain variations of technique. We present what is now an established approach within our centre, but has been enhanced by progressive improvements in the specific surgical instrumentation. The technique is achievable in a smaller centre with lower surgical volumes. We perform a laparoscopic partial nephrectomy using waterjet and advanced bipolar energy without vascular clamping and without renorrhaphy, supplemented with topical hemostatic agents, reliably achieving the stated goals of this surgery. Ischaemia and delayed complications are minimised by avoiding renorrhaphy and vascular clamping during dissection.Zero Ischemia Laparoscopic Partial Nephrectomy for Hilar TumorsOur technique for hilar tumours remains similar to that for peripheral tumours, again using waterjet and advanced bipolar energy without vascular clamping and without renorrhaphy, supplemented with topical hemostatic agents. Waterjet may be safely used directly on major vessels and collecting system structures, and directly on the tumour capsule, to perform either conventional partial nephrectomy with parenchymal margin or tumour enucleation. With hilar dissection, it is possible to visualise and control arterial supply directly to the tumour, reducing the potential for blood loss. The stated goals of this surgery are achieved. The technique which avoids renorrhaphy is particularly relevant in hilar tumours where renorrhaphy may not be technically achievable.
  • Arnulf StenzlGermany Speaker EAU Lecture: AI to Support Informed Decision Making (INSIDE) for Improved Literature Analysis in Oncology.Robot-Assisted Radical Cystectomy and Intracorporeal Neobladder Formation
  • TBD
TICC - 3F Plenary Hall