Doctors at Apollo Multispeciality Hospital, Kolkata saved the life of a 60-year-old patient who was suffering from a rare, complicated kidney disease. cancer Using robot-assisted surgery. The surgery was led by Dr. Tarun Jindal, Senior Consultant, Euro Oncology with the help of da Vinci, an advanced robot-assisted surgery system. This is the first time that a successful surgery to remove cancer from a cross-fused ectopic kidney has been performed in India.

Otherwise asymptomatic, the patient had noticed a lump on his abdomen before deciding to seek medical attention. A CT scan revealed that he had a rare condition called crossed fused ectopia – where both his left and right kidneys were on the right side, with the right kidney above and the abnormal left kidney below it. An 11 cm tumor was also seen emerging from the upper kidney. Crossed fused ectopia occurs in about 1 in 10,000 people, making it relatively uncommon, although not extremely rare. However, tumor development in such cases is considered exceptionally rare.

“The main challenge was to save one kidney and its ureter while dealing with the crisscrossing of both the ureters and blood vessels. Accurately identifying the blood supply to the abnormal kidney, locating the correct ureter to preserve, and removing the ureter associated with the tumor were critical to ensuring accuracy throughout the procedure. If the blood supply to the abnormal kidney is not correctly identified, it can lead to loss or damage to the healthy part of the kidney, leading to further complications. Similarly, if the right ureter is not preserved, it can impair the kidney’s ability to drain urine properly, leading to infection or kidney failure. Proper identification and accuracy is important to ensure the long-term health and recovery of the patient,” said Dr Jindal.

He further added, “We opted for robotic-assisted surgery to carefully preserve the function of the lower kidney, which was less affected by the tumor than the upper kidney. This approach was important to ensure better health outcomes for the patient and avoid the need for dialysis.

An upper polar radical nephrectomy with partial nephrectomy (a surgical procedure in which only part of the kidney is removed) was performed at the level of the junction of the two kidneys using the advanced da Vinci technique, in which the tumor portion of the kidney was removed. given. ensuring that the remaining healthy kidney and ureter were preserved.

Technology played a vital role in this complex surgical case, enabling a minimally invasive approach that would have been difficult without prior experience and advancements. The integration of ICG (indocyanine green) imaging provided real-time insight, helping to differentiate between the two kidneys and their boundaries.

“The use of the da Vinci robotic platform helped me see small blood vessels that would be challenging to identify with the naked eye. This approach significantly reduced the size of the incision, allowing the patient to be discharged within two days instead of the extended recovery time required for open surgery, which would have involved a larger incision. Additionally, blood loss was minimal, eliminating the need for blood transfusion, which would have been unavoidable in an open procedure,” Dr. Jindal added.

The 60-year-old patient said, “I am grateful to the doctors and the entire team for their exceptional care. I was discharged a few days after the surgery and today I am feeling absolutely fit. My health has completely improved and all my tests including creatinine level are becoming normal. I am forever grateful for the expertise and support I have received.”

According to Dr. Tarun Jindal, the patient can live a full, healthy life and no major changes in lifestyle are required. “However, since he now only has one kidney, he must avoid certain medications and antibiotics as part of his routine to prevent damage to his remaining kidney,” he said.

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