Blowfish12: Robotic surgery performed for normalising urinary bladder

Monday, July 9, 2012

Robotic surgery performed for normalising urinary bladder

A seven-year-old girl from Dar es Salaam has a robot to thank for a life reboot.

The Tanzanian girl, who was admitted to Apollo Children’s Hospital after her urethra was crushed in a road accident in her home town, had been subjected to a complex robotic surgery to restore the urinary bladder to normal function.

Ashura Ibrahim had come to Apollo almost a year ago after unsuccessful attempts by doctors in Tanzania to normalize the urinary bladder that left her with a tube hanging from her bladder to pass urine causing physical and mental trauma.

Pediatric urologists found that the child’s bladder was constantly draining to the outside and holding capacity had shrunk. In an open surgery procedure, a flap of the bladder muscle was fashioned into a tube and tunneled to a normal position to serve as the urethra. A few weeks ago, the girl was back for a review and doctors found that in the process of healing, her left ureter had displaced towards the bladder neck and urine was refluxing into the kidney making her prone to frequent urinary infections and renal damage.

After evaluating the options before them, a team led by V. Sripathi, consultant pediatric urologist at Apollo, scheduled the patient for a robotic surgery to stop the urine reflux on June 25. “We ruled out open surgery to cease urine reflux, as it would leave the girl again with a tube to pass urine while a laparoscopy would have been unusually complicated because the ureteral opening was very low,” Dr. Sripathi said.

With the help of the Da Vinci Si robotic system with features such as 3-D field-view and “snake-wrist” arms that can be maneuvered 360 degrees, doctors could create a new bed and suture the ureter into it without reopening the bladder.

Little Ashura is now ready to return home along with her parents. Khery Goloka, Medical Attache, Tanzanian High Commission, Delhi, facilitated the treatment. According to doctors, the procedure was perhaps the first robotic surgery of its kind in pediatrics and the first complex redo on the bladder base.

“Robotic surgery enabled us to achieve a perfect result in a very difficult situation with very minimal morbidity, with no pain and helped achieve discharge within a day,” he said. And, he believed that this more than made up for extra Rs.1 lakh in expenses when compared to conventional intervention tagged at around Rs.80,000.

According to Srinidhi Chidambaram, coordinator for international patient services, Africa accounted for a significant proportion of the 16,000 foreign patient visits last year. Patients from Africa, along with West Asia and the SAARC countries, account for nearly 80 per cent of foreign patient arrivals.

Blowfish12@2012 blowfish12.tk Author; Sudharsun. P. R.