Pune patient's 10-cm cancerous kidney removed through her vagina with minimally invasive technique, done with the help of a robot
The robot used for the minimally invasive surgery
In a rare feat, a 10-cm cancerous kidney was removed from a Pune patient's vagina by using a robot, saving the woman from a conventional procedure, which would have involved opening up her stomach and could have further spread cancer to other parts of the body.
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The surgery was performed on Seema Shah (name changed), 36, who is a resident of Pune, by doctors at the Asian Cancer Institute in a four-hour surgery on April 18. Before the tumour was discovered, Shah thought she was only having troubles in her uterus, which was also later removed in the surgery.
The patient's uterus, and kidney with the 10-cm tumour
Only the uterus
"When she visited the doctors in Pune, she only had complaints about her uterus. She'd been suffering from intermittent abdomen pain during menses for several years and had developed cysts, along with other complicated gynaecological ailments, that needed to be removed. But sonography and CT scan reports showed a renal tumor that was more than 10 cm long," said Dr Jagdeesh Kulkarni, director, minimal invasive and robotic surgery and head of genitourinary and gyno-oncology at the Asian Cancer Institute who performed the surgery on Shah.
Shah's family didn't want her to undergo the conventional open surgery as it could have proved painful and time consuming. "In such surgeries, where both of the organs need to be removed conventionally, the blood loss is severe and patients need to be in the hospital for seven to eight days. But through robotic surgery, just by making some holes in the body, we can operate on the person with minimal invasion, making the blood loss negligible. In fact, the patient was discharged within three days," said Dr Deepak Parikh, medical director of the institute. In this case, the holes were made in Shah's abdomen.
Enter robot
The robotic surgery later performed on Shah was one of the rarest, where first, her uterus was removed through the vaginal passage and then, the kidney was taken out in a pouch to stop the cancer from spreading anywhere else.
"For women, the removal of abdominal mass through a natural orifice like the vagina is feasible in selective instances. We mobilised the kidney mass using robot-assisted surgery and removed it through the vagina after bagging it, since she had to have uterus removal as well. This approach helped her recover early and reduced pain, blood loss, and hospital stay, compared to conventional open surgery," explained Dr Kulkarni. Also calling the surgery 'rare', Ajit Sawant, professor and head of urology at Sion hospital said, "The removal of uterus from vagina is a common procedure, but removing it along with the kidney is unheard of. It seems to be a rare procedure."
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