Mohali, 15 November 2024: A team led by Dr. Dharmender Aggarwal, senior Uro-oncologist and robotic surgeon at Fortis Hospital, Mohali, has successfully performed a complex robotic-assisted surgery to remove a massive 14-centimetre kidney tumour and tumour thrombus (blood clot) from a 62-year-old patient. This advanced surgery, performed with the cutting-edge da Vinci robotic system, is the first of its kind in Punjab, Himachal Pradesh and Jammu & Kashmir, demonstrating the effectiveness of robotic-assisted surgery for high-risk cases.
The 62-year-old patient initially experienced blood in his urine. After initial treatment at local centres, scans revealed a 14 cm tumour in his right kidney, which had completely replaced the organ and formed a thrombus (blood clot) that extended into the renal vein and inferior vena cava (IVC), the main vein returning blood to the heart. The surgery required removing both the tumour and the thrombus from the kidney, renal vein, and IVC, making it a highly complex procedure.
“This type of advanced kidney cancer typically requires a highly invasive procedure, with significant risks of blood loss and complications. However, we opted for a robotic-assisted radical nephrectomy combined with an IVC thrombectomy, a procedure that requires extreme precision to safely remove both the kidney and the tumour thrombus,” said Dr. Aggarwal, adding, “Using the advanced da Vinci robotic system, we carefully dissected the inferior vena cava, placed slings to control blood flow, and removed the tumour thrombus along with the affected part of the IVC. We then repaired the vein, ensuring proper blood flow. The complex part of surgery was completed in just 12 minutes, which would have taken 20-30 minutes in the traditional approach.”
Remarkably, the procedure, completed robotically, resulted in minimal blood loss, far less than in traditional open surgery, eliminating the need for a transfusion. Moreover, adoption of this advanced surgical technique reduced the risk of cardiac arrest and respiratory failure while doing the IVC thrombectomy. The patient was discharged after three days with minimal discomfort, benefiting from quicker healing, reduced pain, and a shorter hospital stay.
The patient expressed his gratitude for the care he received at Fortis Hospital, Mohali, saying, “I was deeply concerned about the risks involved, but Dr. Aggarwal and the entire team reassured me at every step. I am amazed at how quickly I was able to recover and return home.”
This case highlights the capabilities of robotic-assisted surgery for managing complex and high-risk cases. The da Vinci robotic system offers enhanced magnification, greater precision, and reduced blood loss, making it an essential technology for complex surgeries like this.
“We have set a new standard for what can be achieved with surgical robotics in North India. We hope that more hospitals in the region will adopt this technology, and that more surgeons will undergo specialised training in robotic techniques. This is the future of surgery, and it offers significant benefits for both patients and medical professionals alike,” Dr. Aggarwal added.
