Doctors at BLK Super speciality Hospital saved the life of a 12-year old Iraqi child born with congenital defect that caused both his kidneys and ureters to expand abnormally. This was carried out through minimally invasive robotic surgery. The child’s ureter were dilated to 5 cm and elongated to almost 75 cm. Owing to travel restrictions during the pandemic, the child’s medical condition worsened and was in need of an urgent surgery.
Doctors at BLK Super speciality Hospital managed to save his right kidney and shortened the length and re-constructed the ureter and removed the non-functional left kidney through minimally invasive robotic surgery in a single session.
The child when came to BLK Super speciality Hospital had each ureter of 75 cm length as against a normal size of 15 cms. His kidneys were between 20 cms – 25 cms, as against a normal size of 8 cms.
Explaining the case details, Dr Yajvender Pratap Singh Rana– Senior Consultant, Urology and Renal Transplantation, BLK Super Speciality Hospital said, “Master Ali visited us with complaints of stomach pain. On evaluation, he was found to have bilateral obstructive Mega ureter with left non-functioning kidney along with right gross hydro nephrotic and functioning kidney. Mega ureter is a medical anomaly whereby the ureter is abnormally dilated. He underwent robotic surgery for left Nephro Ureterectomy. His ureters were much dilated and almost half of abdomen was filled dilated and enlarged coiled ureters. This coiling led to backflow of urine from the bladder to the kidneys, causing their enlargement.”
Dr Rana explained that the reason for child’s kidneys and ureter becoming abnormally dilated, was due to blockage in his ureters since birth, which went unnoticed for many years which damaged the kidneys.
“If the child hadn’t sought specialised medical care for some more time, his second kidney also would have become non-functional and then child would have become kidney transplant candidate. Normally doctors do an open surgery to correct this condition, but we have corrected this through robotic surgery which is minimal invasive and causes lesser pain, blood loss and scarring. It also reduces the chances of surgical site infection and ensures quicker discharge,” Dr Rana said.
The case was challenging given small frame of the child and smaller abdomen. The operation for both sides obstructed mega ureters highlights the safety of robotics in paediatric reconstructive urology.