Mumbai doctors perform complex laparoscopic surgery on 87-year-old patient

Zaverbai Shyamji Nagda, who underwent laparoscopic excision for a congenital duodenal duplication cyst at Dr LH Hiranandani Hospital, and her grandson Ashish Mukesh Nagda (left). PICS/RITIKA GONDHALEKAR

Zaverbai Shyamji Nagda, an 87-year-old resident of Diva, Thane district, has undergone laparoscopic excision for a congenital duodenal duplication cyst (DDC) - an extremely rare situation, according to doctors at Dr LH Hiranandani Hospital in Powai, who performed the complex procedure. According to doctors, DDC is typically diagnosed and treated in infancy or early childhood.

"Though quite common in the younger or infant population, DDC - where a cyst forms alongside the duodenum, the first part of the small intestine - is an extremely uncommon congenital condition to have been diagnosed at this age. In this unusual case, the cyst remained undiagnosed for decades and was discovered only after the patient began experiencing persistent abdominal discomfort, digestive issues, and vomiting," said Dr Abhijit Joshi, general and advanced laparoscopic surgeon, LH Hiranandani Hospital, adding that the patient had had this condition since her birth, but it was diagnosed only now.

‘This was my first surgery'

Zaverbai told mid-day, "The only medicine that I ever took was for my high blood pressure problem, which started a few years ago. I was never admitted to a hospital in my entire life. So, it was quite scary." While the doctors first tried solving the problem endoscopically, Nagda wasn't comfortable with the tubes. Ashish Mukesh Nagda, her grandson, said, "Frustrated, she insisted on removing all tubes. She would just keep asking to take her home." But the procedure worked wonders. "After the surgery, I could go back to my regular diet. I was fed up with vomiting. I wasn't even able to drink water," Zaverbai said.

Possible world record?

The hospital has now submitted this case report for publication in the journal Annals of Minimal Access Surgery & Allied Science. "When we came across this patient, we pored through the literature to see whether patients of such advanced age had been diagnosed with this ailment. We believe she is the oldest and, thus, felt the need to document it. The case will soon be published," said Dr Joshi.

Medical mystery
Dr Abhijit Joshi, general and advanced laparoscopic surgeon

‘The reason why the condition never bothered the patient for 87 long years is unknown. The challenging part of this surgery was to remove such a large cyst through a laparoscopic procedure instead of opening up the patient.'