The standard procedure to treat a tumour in the kidney is removal of the entire organ. Earlier this month, a team of surgeons in the capital were faced with a unique case of a patient with tumours in both kidneys.
Headed by Dr Rajesh Taneja — who has performed 150 robotic surgeries — the team had to remove the tumours without removing the organ.
“… If there is an injury or disease in one kidney, then the other is sufficient to carry out the (organ’s) function… In this case, the 60-year-old woman had tumours in both kidneys — each one having the potential to be fatal. The traditional standard treatment is removing the whole kidney. Here, we had a situation where the kidneys couldn’t be removed as there were tumours in both. Robotic assisted partial nephrectomy is standard for patients with kidney tumour, but this unique situation made the surgery very challenging,” said Dr Taneja, who works at Apollo Hospital.
He added, “This is the first time that I have performed a robotic surgery that involved the removal of tumours from both kidneys. The risks of the procedure have to be explained to the patient and her family. There could be bleeding while isolating blood supply to the kidney, thus forcing the surgeon to remove the whole organ. Also, while carving out the tumour, some tissue could be left behind.”
After a careful evaluation, the team of five specialists decided to first remove the tumour from the left kidney. Describing the procedure, Dr Taneja said, “Using robotic technology, six small keyholes were made into the abdomen and the kidney was isolated from surrounding structures. The main blood supply of the left kidney, the artery and the vein, were carefully cleared of surrounding fat and other tissues. The vessels were clamped and blood supply to the kidney was stopped temporarily.”
The challenge for the team was to carve out the tumour in 20 minutes. “We used a stopwatch as we had just 20 minutes to keep the blood vessels clamped… Doing it for longer could be detrimental for the recovery of the kidney. The tumour was carved out and the cut was stitched using special suture material. Once we repaired the cut, the clamps from the main blood vessels were removed,” the doctor said.
“The patient was discharged on the third post-operative day,” the specialist said. Five weeks later, the same procedure was repeated on the right kidney.