New Delhi: Usage roboticsdoctors in Sir Ganga Ram Hospital recreated the urinary bladder in a 60-year-old man suffering from invasive cancer.
Taking the patient’s condition into account, the physicians considered the best surgical treatment to be complete removal of the bladder, followed by the creation of a new urinary bladder.
This new bladder is usually made using a part of the small intestine, to which both kidneys are later attached. Traditionally, this complex surgery is performed through a large cut in the abdomen, resulting in much morbidity and longer recovery times for patients.
The medical team, consisting of Vipin Tyagi, senior consultant, robotic surgeon, department of urology and renal transplantation, and Tarun Mittal, senior consultant, department of laparoscopic surgerydecided to rebuild the urinary bladder using robotic technology.
“There was a 30% chance of minor or major complications in the traditional approach. One of the main causes of this significant morbidity is the longer incision and increased blood loss. To avoid these complications, we decided to use an unusual approach of robotic-assisted laparoscopic surgery in this patient,” said Dr. Tyagi.
The patient was assisted by robot radical cystectomy followed by urinary diversion. This robotic surgery included three steps: First, the entire bladder along with the cancer was removed with the help of a robot. In the second step, a part of the small intestine that was about 15-20 cm in length was harvested. In the third step, this removed part of the small intestine was used to create a new bladder pouch, which was eventually joined with the tubes from the kidneys (ureter).
All three steps were performed by a clinician sitting at the robot console and using a robot-assisted laparoscopic approach. In this way, the procedure was completed with just making a few small keyholes, thus avoiding large incisions.
“Because there was no major cut, incision-related post-surgical complications were avoided. The main advantage of using a robot was that it helped us remove the entire cancer and create a new, functional bladder,” said Dr. Mittal.
The entire process took approximately six hours with minimal blood loss. The patient was discharged six days after surgery.
