Doctors at the BLK-Max Super Specialty Hospital in Delhi have performed a breakthrough robotic surgery with only 20 minutes window to remove a tennis ball-size renal cyst from a 15-year-old girl. She was born with abnormalities that caused both of her kidneys to fuse together on the left side.
She never knew about her condition and learned about it two years ago. She had a lingering dull pain on her left side on and off as she grew up. But two years ago, the dull pain that she felt turned into pinching pain that lasted for ten minutes. When the frequency of the episode increased that’s when the family consulted doctors.
Dr Surender Dabas, Senior Director and HOD, Surgical Oncology and Robotic Surgery of the hospital, said that this case was one of the most complicated and complex cases, he has handled in his 30 years of career as a surgeon.
While speaking to the media Dr Dabas said, “Deepali was born with a fused kidney on the left side of her body and for practical purposes had no right kidney. She had a large cyst of 10X10 cm in that fused kidney, which required immediate surgical intervention. To worsen matters, the location of the cyst was very tricky as it sat on an overlapping area of the ureter, renal arteries and veins. Not only that, the renal vessels and ureter were abnormally intermingled with the cyst and injury to any of these structures would have been catastrophic to the patient.”
Dr Dabas further mentioned the surgery was so delicate that even a slight tilt would have led destroy the solitary kidney, and they would have to remove it. Then Deepali would go on the transplant list and would confine to a life-long protocol of immunosuppressant.
The challenge for doctors was to open up the kidney and remove the whole tumour to prevent recurrence and suture it back without damaging the kidney. “Given the delicacy of the surgery, we had to stop the renal artery for some time. We had just a window of 12 to 20 minutes. That’s why I chose a high-precision robotic surgery. Not only were we able to execute it neatly, but we were also able to save the kidney,” added Dr Dabas.
Dr Dabas also mentioned that the patient successfully underwent robotic excision of the cystic mass. The small structure of the child and smaller abdomen made the case challenging. The doctors were able to dissect the whole mass with minimal blood loss. The technique left Deepali with minimal scarring.
Deepali had a swift recovery without any post-op complications and was discharged on the fourth day after the surgery.
