Rohit Shishodia

Doctors at a Delhi hospital gave a new lease of life to a 15-year-old girl by carrying out complex robotic surgery by removing a 10x10 renal cyst from her lone kidney.

The case was challenging as the doctors had to remove the cyst while ensuring minimal damage to the solitary kidney of the child along with its blood vessels and ureter. In this case, the renal vessels and ureter were abnormally intermingled with the cyst and injury to any of these structures would have been catastrophic to the patient.

The patient, Deepali was born with developmental abnormalities that caused both of her kidneys to fuse together on the left side and subsequently she was left without a right kidney.

Dr Surender K Dabas, Senior Director and HOD, Surgical Oncology and Robotic Surgery at Delhi’s BLK-Max Super Specialty Hospital said that to the best of his knowledge it was a rare case and not reported anywhere where cyst developed in the middle of ureter while kidney was preserved after the surgery. The size of cyst was bigger than the kidney.

 “The only solution of removal of the cyst in the fused kidney was surgery and it was challenging for us to ensure the cyst removal while preserving the kidney at the same time. We performed robotic technology to remove the cyst. Using firefly technology, which can differentiate cyst and kidney, we could clearly see the cyst and kidney during the ultrasound. We could also see urinal arteries and veins,” Dr Dabas added.

“This was one of the most complicated cases to handle. Deepali was born with a fused kidney on the left side of the body and an absent right kidney. She had a large cyst in that fused kidney and which required immediate surgical intervention. Making use of robotic technology, meticulous dissection of the surrounding structures, blood vessels and ureters, the team was successfully able to dissect the cystic mass with minimal blood loss and preserve the surrounding structures,” he explained.

The patient made a swift recovery without any post-operative complications and was discharged on the fourth day after surgery, he further informed.