In A Rare Feat, 45 YO Woman Walks Within 6 Hrs. Of Dual Robotic Surgery In A Single Operation At HCGMCC

Dr Raj Nagarkar Employs Natural Orifice Surgery To Simultaneously Remove Kidney Tumour & Uterine Fibroids

Nashik, March 26: Prof Dr Raj Nagarkar, Chief of Surgical Oncology & Robotic services of HCG Manavata Cancer Centre (HCGMCC), recently achieved a remarkable milestone by performing two distinct surgeries on a woman in a single operation using robotics. The patient, a 45-year-old resident of Malegaon, faced the dual challenge of left kidney cancer and multiple large uterine fibroids, compounded by high BMI, hypertension, diabetes and respiratory issues. Undeterred by the complications, Dr Nagarkar orchestrated a swift and efficient three-hour procedure by performing both a nephrectomy (kidney removal) and a hysterectomy (uterus removal) employing the innovative Natural Orifice Transluminal Endoscopic Surgery (NOTES) technique. This unique approach minimized surgical trauma and maximized precision, enabling the patient to walk independently just six hours after the surgery, heralding an extraordinary advancement in the management of complex medical conditions.

“Despite the complexities posed by high BMI, hypertension, diabetes and respiratory issues, our team rose to the challenge with an innovative approach. We executed a rapid three-hour nephrectomy and hysterectomy in a single operation, providing a comprehensive solution to the patient’s health concerns. Utilizing advanced dual surgery techniques, we removed the kidney and uterus through minimally invasive incisions in the abdomen and vagina. Leveraging robotic technology, we methodically dissected and separated the affected organs and surrounding tissues, thereby minimizing surgical trauma and maximizing precision,” says Dr Raj Nagarkar, Managing Director & Chief of Surgical Oncology & Robotic Services, HCG Manavata Cancer Centre (HCGMCC) & Hospitals.

For a height of less than 5 feet, the patient weighed over 100 kg which posed health risks, including high blood pressure and elevated blood sugar levels. The patient complained of persistent abdominal pain and irregular menstrual cycles with excessive bleeding over the last few months.

“A gynaecologist’s ultrasound revealed not only a large fibroid uterus but also a suspicious 6 to 8 cm kidney swelling, possibly indicative of cancer. Upon evaluation, the patient was diagnosed with left kidney cancer and multiple large uterine fibroids, presenting a dual challenge for her health. Distressed by the diagnosis, the patient turned to us for further evaluation and treatment. A CT scan confirmed the presence of kidney cancer, fortunately confined to the affected kidney. To address both, the kidney tumour and uterine fibroids, the patient required major surgeries. We are glad that through the Natural Orifice Transluminal Endoscopic Surgery (NOTES), we were able to mitigate any collateral risks to the patient’s health despite the comorbidities,” adds Dr Nagarkar.

The successful outcome highlights the transformative potential of robotic-assisted natural orifice surgery in addressing complex medical conditions. Through innovative techniques and advanced technology, HCGMCC continues to pioneer cutting-edge treatments, offering hope and healing to patients facing challenging health issues.

“The benefits of the NOTES approach were manifold. The patient experienced minimal scarring, with only five small incisions of not more than 5 to 10 mm on the abdomen. Remarkably, they were able to walk within six hours post-surgery, resumed oral intake the following day and was discharged home on the third day, without requiring significant pain management. Moreover, the risk of bleeding and infection was markedly reduced, underscoring the advantages of robotic-assisted NOTES in select patient populations,” concludes Dr Nagarkar.