Outcomes & experience

Why experience matters in kidney surgery — and how this practice benchmarks its work against current international standards.

3,000+ Robotic procedures performed
3 Sydney consulting locations
Pioneer Laparoscopic kidney surgery in Australia
FRACS Fellow of the Royal Australasian College of Surgeons (Urology)

Experience

Dr Raji Kooner is a senior Sydney urologist with a longstanding interest in kidney disease. He was among the first urologists in Australia to perform laparoscopic and robotic removal of kidney tumours, and was an early adopter of robotic-assisted urological surgery. Over his career he has performed more than three thousand robotic procedures.

That depth of experience matters: published research in urology consistently shows that higher-volume surgeons and higher-volume centres achieve better outcomes for complex kidney surgery, including shorter operating times, lower complication rates, and better preservation of kidney function after partial nephrectomy.

How we measure "a good outcome"

For kidney cancer surgery, Dr Kooner uses the internationally recognised "trifecta" standard for partial nephrectomy:

The partial nephrectomy trifecta

1 Negative surgical margins — complete tumour removal
2 Preserved kidney function after surgery
3 No significant post-operative complications

Achieving all three elements together is the standard by which modern kidney cancer surgery is judged.

For kidney stone surgery, the analogous standard is complete stone clearance in as few procedures as possible, without infection or bleeding. The goal is "stone-free" — not merely "fragmented and hoping for the best."

Multidisciplinary care

Complex kidney disease is rarely the responsibility of one specialty alone. Dr Kooner works alongside:

  • Medical oncologists for patients with advanced kidney cancer needing systemic therapy.
  • Nephrologists for patients with chronic kidney disease, polycystic kidney disease, or kidney transplants.
  • Radiologists experienced in uro-oncology imaging and image-guided procedures.
  • Endocrinologists for functioning adrenal tumours.
  • Anaesthetists who regularly work with robotic kidney surgery.
  • Stoma nurses, physiotherapists and dieticians where rehabilitation and recovery require it.

Tracked metrics

Dr Kooner reviews his own outcomes regularly, in line with professional standards. Metrics routinely tracked include:

  • Conversion from keyhole to open surgery.
  • Positive-margin rate for partial nephrectomy.
  • Estimated blood loss and transfusion rate.
  • Length of hospital stay.
  • 30-day and 90-day complication rates (Clavien-Dindo).
  • Stone-free rates for stone surgery.
  • Patient-reported recovery.

Outcome figures for individual patients are discussed at consultation, as they depend on the specific procedure, the stone or tumour involved, and the patient's overall health.

Publications & contributions

Dr Kooner has contributed to the Australian urological community through clinical work, peer teaching and occasional publications. A dedicated Media & Publications page lists specific items.

If you are comparing surgeons for your care: fair questions to ask any urologist include "How many of these operations do you perform each year?" and "What are your typical complication and stone-free rates?" Dr Kooner is happy to answer both at consultation.

Speak with Dr Kooner's rooms

Arrange a consultation or request a second opinion on kidney cancer, stones, or reconstructive kidney surgery.