@ Vikash Sharma | Sr Journalist
New Delhi: Doctors at BLK-Max Super Speciality Hospital, one of North India’s leading healthcare provider, have saved the life of a 15-year-old girl born with single fused kidney by removing a large renal cyst measuring a 10X10 cm in size, through robotic surgery.
The case was challenging as the doctors had to ensure removal of the cyst while ensuring minimal damage to the solitary kidney of the child along with its blood vessels and ureter. In this case, 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.
The surgery was performed by the team led by Dr Surender Dabas, Senior Director and HOD, Surgical Oncology and Robotic Surgery, BLK- Max Super Specialty Hospital.
15-year-old girl Deepali, was born with development abnormalities that caused both her kidneys to fuse together on the left side and had an absent right kidney.
Deepali came to BLK – Max Hospital with complaints of on and off pain in the left flank for over 18 months. Detailed contrast enhanced CT scan also revealed the presence of horn like structure on the left side of intestine, enlarged left kidney with left renal para pelvic cyst, absent right kidney, unicornuate uterus and undescended right ovary.
The cyst measured 10X10 cm in size (size of a tennis ball) in the fused kidney with renal vessels and ureter around it.
“This was one of the most complicated cases to handle. Deepali was born was fused kidney on the left side of her body and had an absent right kidney. She had a large cyst in that fused kidney and which required immediate surgical intervention. Challenge in the case was removing the cyst while ensuring minimising of any damage to the solitary kidney, the ureter and the renal vessels. After evaluation, we decided to perform high precision robotic surgery to remove the cyst. She successfully underwent robotic excision of the cystic mass. Making use of robotic technology, meticulous dissection of the surround structures, blood vessels and ureters, the team was successfully able to dissect the cystic mass with minimal blood loss and preserving the surrounding structures,” said Dr Surender Dabas Senior Director & HOD, Surgical Oncologyand Robotic Surgery, BLK- Max Super Specialty Hospital.
Due to the use of robotic surgery, the patient made a swift recovery without any post-op complications and was discharged on the fourth day after surgery.
Para pelvic renal cyst, are usually situated on the hilum of the kidney and over a period of time could lead to compression on the renal pelvis, blood vessels, other organs and lymphatic vessels. Pertaining to the serious complications associated with the cystic mass, can also cause uronephrosis, reno-vascular hypertension, and ultimately renal failure.
As this patient had fused kidney, absence of right kidney would have caused serious complications if the treatment was delayed.
Normally doctors use open surgery to correct this condition, but we corrected this through robotic surgery which is minimally invasive and causes lesser pain, blood loss and scarring while helps in early postoperative recovery and less hospital stay . It also reduces the chances of surgical site infection and ensures quick discharge,” said Dr Dabas.
The case was also challenging given small frame of the child and smaller abdomen, and the one of its kind treatments provided to the young girl has highlighted the safety of robotic procedures among the pediatric group as well.