August 03, 2018 06:54 PM

Ludhiana (Face2News)

In a boon to kidney failure patients, robotic kidney transplants have now become a reality and are being successfully conducted at Fortis Hospital in Mohali. Unlike the traditional kidney transplantation where the patient receives a kidney through a large muscle cutting incision ( approximately 25-30 cms), in Robotic kidney transplant, the kidney is placed through a small 5 centimetres incision, in the belly button, without cutting any muscle.

Because of this the blood loss is significantly less, chances of infection are minimal, there is hardly any pain and the patient’s recovery are quick. It’s been a significant revolutionary medical advancement in the lives of the patients, which is very helpful for their recovery. Now Chandigarh becomes the third city in the country and tenth center in the world to regularly offer this highly sophisticated surgery. Till date nine patients have received a successful kidney transplant through this technique and we are getting numerous patients in the waiting list for the same.

The latest surgery was done on 25th July at Fortis Hospital, Mohali, where a sister donated his kidney to her brother. The surgery was done by the noted Urologist and transplant surgeon, Dr Priyadarshi Ranjan, senior Consultant in Urology, Robotics and Kidney Transplantation At Fortis Hospital, Mohali. Achieving this extraordinary surgical feat places Dr Ranjan in top ten surgeons in the world, who are capable of doing a successful robotic Kidney Transplantation. Till date we have done nine patients and all of them are living a healthy life with a functioning kidney now, said Dr Ranjan. Unlike the traditional regular kidney transplantation, where the patient receives the kidney through a larger muscle cutting process, robotic surgery is conducted with only a small incision and involves no cutting of muscle.

The Da Vinci robot is used in a specific way to ensure tremor free movement of the instrument thus causing no damage to the graft kidney. This ensures minimal chances of infection and faster recovery of the patient and the donor. Sirsa resident Boti Devi(55) donated the organ to her son Sandeep (23) after he was admitted to the hospital with renal failure. “The family was apprised about the latest robotic technology and its benefits, including lesser risk of infection, lesser pain, and a faster return to normalcy. Higher magnification and finer scaled miniaturised movements of robotic instruments ensured greater precision in this surgery”, said Dr Ranjan.

The surgery is currently done at very highly advanced centers in the United states and France only apart from two cities in India, namely New Delhi and Gujrat. Doctors said that the particular robot has been in use previously for other ablative surgeries such as kidney and prostate cancer, but now we have started using it for a kidney transplant as well. Elaborating on the journey, Dr Ranjan added learning robotics surgery was an uphill task. A surgeon has to cross many stages before he can take up robotic kidney transplantation. It beings with a set of computer generated simulation exercises, followed by hands on training on animals and cadavers and then humans. Initially we do ablative surgeries by the robot, like kidney and prostate cancer in which the organ is diseased and needs to be discarded and then slowly progress towards kidney transplantation in which utmost care is needed to preserve the kidney during Transplantation or else it will not work. The traditional technique of kidney transplant has remained unchanged for almost sixty years as predominantly it was done by Non Urologists, but now since the last few years when the Urologists have been involved in Kidney Transplantation, the technique has evolved into robotic surgery, significantly improving the overall transplant outcomes and thus passing on the benefits to the patients. Since we regularly do robotic surgery for other kidney diseases such as kidney cancer or stones, so it’s more familiar to work on the robot for such a complex procedure, added Dr Ranjan. The cost of this transplant is marginally higher than a regular transplant process which is worth Rs 5-6 lakhs,” Ranjan added. Elaborating the benefits of robotic transplant surgery, Dr Ranjan told the there is significantly less blood loss, less chances of infection and the post-operative recovery is excellent. The surgical precision is much enhanced as the surgery is conducted under 3D magnified view and surgical hand tremors are minimised hence there is better surgical control than even open surgery. Several patients who have received a robotic transplant were present on the occasion and shared their experiences. It has been a privilege to perform Punjab’s first robotic kidney transplant at the hospital considering it is the first of its kind in The state, said Ranjan. The team worked together and we are thrilled that all the patients and the donor are doing well and all the operations have been a great success,” Ranjan said, who has a rich experience of more than a thousand traditional transplants. These patients were on dialysis for a varying duration. He said, “The robotic surgery involved much lesser pain.

I was initially reluctant, but the doctors convinced me about the benefits. I am happy that I went ahead with it.” Narrating his experience, Beena said, “I decided to give my kidney for my husband’s normal life,” who added that she did her own research about the surgery before going ahead with it. Patients suffering from chronic renal diseases tend to prefer renal replacement compared to dialysis for various reasons.

Only three centers in India including Fortis Mohali have been regularly and actively performing these transplants as of now, with excellent results. Robotic kidney transplant is going to be the future in next decade. The incidence of adverse medical events and complications is one fifth to one tenth of a traditional kidney transplant and the benefits are immense. The kidney function and overall patient’s recovery is far superior than a traditional transplant. The patient has a very small incision, so his natural daily life is not altered after the transplant. The problem however is of it being a technically complex procedure and hence there a only a few surgeons who are able to perform this procedure and deliver good results. The learning curve is steep, thereby dissuading many surgeons from taking it up, hence practiced only in select elite institutions of the world.

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