The Department of Uro-Oncology and Robotic Surgery, Fortis Hospital Mohali, has successfully treated multiple patients suffering from complex urological cancers via the world’s most advanced 4th Generation Robot – Da Vinci Xi.
Dr Dharmender Aggarwal, Consultant, Uro-Oncology and Robotic Surgery at Fortis Hospital Mohali, has treated two such patients through robot-aided surgeries.
In the first case, a 56-year-old patient, who had undergone a renal transplant in 2018 due to chronic kidney disease, found a 3-cm tumour in his transplanted kidney. He approached Dr Aggarwal at Fortis Mohali where following subsequent examinations, Dr Aggarwal performed Robot-assisted transplant kidney partial nephrectomy (removing part of the kidney to treat a disease). The Patient’s renal vessels were dissected and the tumour was removed, while preserving the kidney. He had good urine output post-surgery and did not require transfusion or dialysis. The Patient started walking 10 hours after the surgery and was discharged on the third day. He has recovered fully and leading a normal life today.
Discussing the case, Dr Aggarwal, said, “The case was complex as it was difficult to dissect around the transplanted kidney and make proper planes. Most of the times, the kidney and surrounding tissues are stuck due to previous surgeries. Any delay in medical intervention would have caused the tumor to grow in size and impact the other organs.”
In another case, a 62-year-old patient was experiencing blood in his urine from the last 10 days. On subsequent evaluation, he was found to have a large tumor in his right kidney (14 cm) along with a thrombus in his renal vein and a large blood vessel inferior vena cava. The Patient approached Dr Aggarwal where following a PET scan and other medical investigations, Dr Aggarwal suggested robot-aided surgery was a line of treatment to the patient. The team of doctors led by Dr Aggarwal performed Robotic Radical Nephrectomy with IVC Thrombectomy of large kidney lesion and were able to completely remove the entire tumour along with thrombus in the large vein. The case was complex as the tumour involved a large vein going towards the heart, which posed a risk that the tumour thrombus could get dislodged and go into the heart, causing a cardiac arrest.
Discussing the case, Dr Aggarwal, said, “The entire IVC was dissected and control was taken at three points to avoid any such problem. The Patient had a smooth post-operative recovery post surgery and was able to walk within 8 hours of the procedure. He was discharged after three days.”
On the benefits of robot-aided surgeries, Dr Aggarwal, said, “Compared to the usual stay of 8-10 days in an open surgery, Robot-aided surgery allows a patient to walk on the same day of the procedure. With the help of newer technologies, we are now able to remove only the tumour and save the kidney in most of the cases. Robot-aided surgery is the latest form of minimal invasive surgery and provides a 3D view of the operative field via a special camera inserted into the body of the patient. Parts of the body which are difficult to reach with the human hand can be accessed through robot-assisted arms that can rotate 360 degrees.”
Dr Dharmender Aggarwal has undergone training in complex cancer surgeries and Robot-aided Surgery from London, and has performed more than 550 robotic surgeries cases till now.
