December 2012

Robotic Surgery Removed 15 cm-long Tumour

Robotics Surgery


The cancerous tumour was removed through a keyhole with the use of new state- of-art da Vinci Si Robotic Surgical System. Nikita Apraj, ENN presents a report

Arun Kumar (name changed), 51 was feeling relieved when doctors at Asian Heart Institute (AHI),  Mumbai, told him that sonography reports of his abdomen have come clean. Just a month ago Kumar was operated in AHI for a complex renal surgery, where doctors removed a cancerous  tumour as large as 15 cm from his kidney through a robotic procedure. According to doctors, the case is unique due to the massive size of the  cancerous tumour and the fact that it was operated as a robotic procedure with  minimal blood loss and pain. The surgery was done by Dr Jagdeesh Kulkarni  and Dr Mangesh Patil from Asian Robotic Surgery Institute, a unit of AHI.
There are very less literature reports from India but the large renal tumours usually means approximately 10-12 cm in literature, said doctors.
Normal size of kidney is 10 x 6x 4 cms. Robotically a tumour removed in everyday practice is about 4-5 cms long. But in this case the size of the
renal tumour was approximately 15 cm and was removed completely by robotic surgery through a key hole size of 3-4 cm and the patient is doing well now, said Dr Jagdeesh Kulkarni, Onco-Urologist, Panel Robotic Consultant, AHI.
Kumar, who also had a thyroid issue, consulted his family doctor when he suddenly started losing weight few months ago.
My doctor suggested me to undergo check up and do my abdominal ultrasonography. I was shocked when the test revealed that I have such a big cancerous tumour growing inside my kidney, said Kumar.

Unique features of robotic procedure in this case
Complete removal of renal tumour without spillage
Minimal pain to the patient
Highly accurate, so no chance of error
3D vision which gives more precision


The complete surgery was done robotically on September 7th . Doctors  removed the tumour through the keyhole as a single complete mass without  crushing and spillage to prevent recurrence of cancerous growth. This is  probably the first time in the country that such a huge mass has been removed as a single piece through a keyhole. The surgery was challenging as well because of the size of tumour. Ordinary surgeons would have suggested open surgery,  which would have caused a lot of pain and discomfort to the patient, said Dr  Mangesh G Patil, Consultant Urologist and Robotic Surgeon, AHI. Long Hospital stay is a disadvantage of open surgery.
It was a high risk procedure from patients point of view because cancer-cure is the most important. It was challenging to remove such a big tumour through a keyhole. Patients life depends a lot on the intra-operative and post-operative   management. The blood loss during this procedure was less than 50 ml.
Dr Ramakanta Panda, Vice Chairman & Managing Director AHI, said, The Asian Robotic Surgery Institute is the first institute in Mumbai to offer robot assisted  surgeries. The institute has recently completed more than 100 robotic surgeries with the highest success rates, thereby setting a new benchmark in Indian healthcare.

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