Friday, September 8, 2017

Renal hydatid cyst removed by robotic surgery


PUNE: A 37-year old patient couldn't fathom what was wrong with him. For the past few years, he was suffering from pain in the flank. After multiple tests such as sonographies and CT scans, he was detected with with a cyst almost replacing the right kidney known as the hydatid cyst, a rare condition seen in only 0.2% of renal cysts. Last month, he became the first person in India to have undergone a robotic surgery for a renal hydatid cyst at Ruby Hall Clinic.

Hydatid cyst of the kidney is a very rare condition caused by the larval stage of Echinococcus granulosus. It is endemic in parts of the Middle East, South America, Australia, New Zealand, Alaska and stockbreeding regions of North-west China and India. More commonly seen in the liver and lung, this disease forms 1–5% of all hydatid disease in humans across the world. Explains Dr. Rajendra Shimpi, Head - Urology Division, Ruby Hall Clinic, “An extremely rare case, this is probably the first time in world medical literature that a renal hydatid cyst has been operated upon with robotic assistance. The surgery was a challenge due to the large size of the cyst and the possible severe anaphylactic shock due to accidental spillage of the cystic fluid and the dissemination of the daughter cysts in the abdominal cavity leading to extensive hydatid disease in the abdominal cavity.”

“In the robot-assisted surgery, the cystic fluid was aspirated with all precautions to avoid  spillage of  the contents  in the abdominal cavity and then scolicidal fluid was injected in the cyst. Carefully the cyst along with the germinal layer was excised. The actual surgery took 2 hours with the blood loss of less than 100 ml. Due to the magnification and precision which can be achieved with the robotic surgery, a part of the kidney could be saved, other wise the patient would have lost the entire kidney. The patient was discharged on the third post operative day and could resume his duties in 1-2 days as the surgery is done through small holes in  the abdominal wall,” he concludes.

This surgery comes after Ruby Hall Clinic became the only hospital in Pune to have acquired the Da Vinci Si Robot earlier this July. Says Dr. Manisha Karmarkar, Head - Department of Robotic Surgery, Ruby Hall Clinic, “Health care faces diverse issues of quality, access and cost, many of which can be addressed by appropriate application of technology. Very few institutions in the country have surgeons who are experts in this type of advanced robotic minimally invasive surgeries. While we have used robotic surgery successfully in the fields of gynaecology, urology and even general surgery to name a few, this very rare case is part of our continued commitment to the advancement of medical technology for the better treatment of the patient and the greater efficiency of the hospital.”

Bomi Bhote, CEO, Ruby Hall Clinic adds, “I believe this marks a big step in the advancement of robotics and the introduction of advanced technology to the operating room. With a robotic system and experts performing never-seen-before cases, we open up a whole new chapter of operations that could not have been performed otherwise.”


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