New Delhi: Using robotics, doctors at Sir Ganga Ram Hospital recreated the urinary bladder in a 60-year-old male who was suffering from invasive cancer.
Considering the condition of the patient, the doctors felt the best surgical treatment was the complete removal of the bladder, followed by the creation of a new urinary bladder.
This new bladder is usually made by using a part of the small intestine, to which both kidneys are subsequently attached. Traditionally, this complex surgery is performed by making a big cut on the abdomen, which results in lots of morbidities and longer recovery times for patients.
The team of doctors, consisting of Vipin Tyagi, senior consultant, robotic surgeon, department of urology and kidney transplant, and Tarun Mittal, senior consultant, department of laparoscopic surgery, decided to reconstruct the urinary bladder using robotic technology.
“There were 30% chances of minor or major complications in the traditional approach. One of the major causes of this significant morbidity is the longer incision and more blood loss. To avoid these complications, we decided to use an uncommon approach of using robotic-assisted laparoscopic surgery in this patient,” said Dr Tyagi.
The patient underwent robotic-assisted radical cystectomy followed by urinary diversion. This robotic surgery included three steps: first, the complete 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 harvested part of the small intestine was used to create a new bladder pouch, which was finally joined with the pipes of kidneys (ureter).
All the three steps were executed by a doctor sitting on the console of the robot and using a robotic-assisted laparoscopic approach. In this way, the procedure was completed by just making a few keyholes, thus avoiding any major incisions.
“As there was no major cut involved, post-surgical incision-related complications were avoided. The major advantage of using a robot was that it helped us to remove complete cancer as well as create a new functional bladder,” said Dr Mittal.
The whole process took approximately six hours with minimal blood loss. The patient was discharged six days after surgery.