Panipat: In a first, doctors at BLK-Max Hospital, New Delhi, successfully performed Robotic pyeloplasty surgery on a 2-year-old toddler, to treat the blocked ureter. This is the first such robotic case to be performed on a toddler in India.
While the management of Pelvi-Ureteric Junction obstruction requires pyeloplasty which can eb performed either by conventional open surgery, laparoscopic techniques or robotic procedures, the team of doctors at BLK Max Hospital successfully performed it through the latter.
Since the open surgery has the disadvantage of large incision, post operative pain and longer hospital stay, robotic surgery was preferred due to its high definition and magnification with 7 degrees of freedom movement, allowing he surgeon to precisely reconstruct with minimal incision, negligible pain and quicker recovery & discharge.
“The 2-year-old girl presented with history of fever and abdominal pain in the left lumbar area, and detailed examinations revealed a palpable left kidney and was suffering from Urinary Tract Infection (UTI). Further investigation through ultrasound were suggestive of enlarged left kidney with severe hydronephrosis with thinning of renal cortex, suggestive of pyonephrosis. She was immediately started on intravenous antibiotics for treating the pelvi-ureteric junction obstruction with pyonephrois, for which she responed well. After the infection got settled renal scan was done to confirm the diagnosis which revealed obstructed system with poorly functioning kidney. The child was planned for robotic surgery and robotic pyeloplasty was done. This required resection of pelvi-ureteric junction and spatulated anastomosis of pelvis and ureter. The surgery was uneventful and the child was discharged on 2nd post operative day.” Said Dr Prashant Jain, Director- Paediatric Surgery & Coordinator Paediatric Super Specialties, BLK-Max Super Specialty Hospital, New Delhi
Since the inception of robotic technology in medical science, its current application in children have expanded in performing wide range of pediatric urological surgeries like pyeloplasty in pelvi-ureteric junction obstruction, ureteric reimplant in vesicoureteric reflux, heminephrectomies, renal tumors etc.
Although it is also being used now in thoracic and gastrointestinal surgeries. The surgery can be performed in all age groups including newborns and infants. The current available studies suggests that the safety and outcome of RAS surgery are almost same as compare to other conventional surgeries.
Looking at the advantages of robotic surgery it is important for us to provide its benefits in pediatric population. The safety and the surgical outcome of RAS will surely revolutionize the surgical management in children.
In robotic assisted surgery surgeon sits beside patient on a console and manipulates robotic arms with articulated instruments which are controlled by surgeons’ hands. The surgeons hand movements are transmitted inside the patient’s body to perform precise dissection and suturing.
The RAS has advantages of providing high definition and magnified 3D vision along with 7 degrees of freedom of movement.
This has advantage especially in children because of their miniature size. This helps surgeon not only to perform surgery with great precision but also it significantly reduces his surgical stress. Like any other minimal invasive surgery RAS has advantage of less postoperative pain, minimal incision, less morbidity and early hospital discharge.