First robotic kidney tumor removal surgery in AP and Telangana performed at AIG Hospitals
Hyderabad: Urologists at AIG Hospitals have successfully performed the first-ever robotic retroperitoneal partial nephrectomy for a renal tumor in a patient with Chronic Liver Disease (CLD). This minimally invasive procedure, which involved removing only the tumor from the kidney instead of the entire organ, marks a significant milestone in the twin states of Andhra Pradesh and Telangana.
The surgery was led by Dr. Bipin Chandra Pal, Director and Head of Urology and Renal Transplantation at AIG Hospitals. The patient, a 45-year-old woman with a history of CLD and ascites, had been experiencing right flank pain, fatigue, and generalized weakness. A high-resolution contrast-enhanced CT scan revealed a 4 cm x 4 cm cancerous tumor in her right kidney, which was affecting kidney function. Further complicating her case, the patient had a 5 cm enlarged liver (hepatomegaly) and moderate ascites, making conventional surgical approaches risky.
"The traditional abdominal laparoscopic or robotic approach was not feasible due to the ascitic fluid, fragile liver, and proximity to intestinal structures," explained Dr. Pal. "Instead, we opted for the retroperitoneal approach, which bypasses the abdominal cavity entirely. This approach is more complex but allows for a safer and more targeted surgery, especially for high-risk patients like this one."
The retroperitoneal technique involves accessing the kidney from the side of the body, avoiding disturbance to internal organs such as the liver and intestines. Given the tight, confined space, the use of advanced robotic technology allowed the surgical team to operate with high precision and successfully remove the tumor while preserving surrounding organs.
Dr. Mithun Sharma, Director and Head of Hepatology at AIG Hospitals, noted that patients with liver cirrhosis face heightened risks during surgery, including infections, complications, and slower recovery. "The robotic retroperitoneal approach minimizes invasion, reduces the risk of fluid leakage and infections, and avoids sudden changes in blood flow that can exacerbate liver-related issues," he said.
Dr. D. Nageshwar Reddy, Chairman of AIG Hospitals, highlighted the multidisciplinary effort involved in the surgery. "A patient with chronic liver disease and a complex renal tumor traditionally faces a higher surgical risk and longer recovery. With careful planning and collaboration among hepatologists, urologists, radiologists, and anesthetists, we were able to provide a safe, organ-preserving solution with a rapid recovery."
During the surgery, an intraoperative ultrasound was used to delineate the tumor's boundaries in real time, ensuring maximum preservation of healthy kidney tissue. The tumor was successfully removed, and the kidney was repaired.
Post-surgery, the patient experienced minimal pain, no complications, and was discharged within 48 hours, an exceptional outcome in high-risk cases. Pathology confirmed the complete removal of the tumor, and renal function was preserved.
