Kidney Infection Settled and Urinary Passage Reconstructed with a Complex Robotic Surgery

When 30-year-old Mini Sahu from Jhansi underwent surgery for a kidney stone at a local hospital, she hoped it would bring relief. Instead, within days, she began experiencing severe health problems. High fever, weakness, and dangerously low blood pressure forced her to seek urgent medical care. That is when she arrived at Sarvodaya Hospital, Sec 8, Faridabad, where she consulted with Dr Sumit Bansal, Senior Consultant & Head - Kidney Transplant & Urology.

At the hospital, initial tests revealed a large intra-abdominal abscess, a pocket of infected fluid and pus, that had formed around the left kidney area where the previous surgery had been performed. The infection was severe and had begun affecting her overall condition.

She had a high fever and low blood pressure. She was first stabilised medically with strong antibiotics and supportive care. To control the infection, Dr Sumit and his team drained the pus collection and placed a special tube into the kidney to safely divert urine and infected fluid outside the body. This helped reduce pressure on the kidney and allowed the infection to gradually settle.

Complex Robotic Boari Flap Ureteral Reconstruction

Once her condition improved, doctors conducted detailed imaging to understand what had caused the complication. The findings revealed a rare and serious problem. The ureter (the delicate tube that carries urine from the kidney to the bladder) had been badly damaged due to infection, leading to necrosis (tissue death). Only a very small segment of the ureter was still attached to the kidney, while the rest of the passage had been disrupted.

Without a proper urinary pathway, urine could not flow normally from the kidney to the bladder, which had led to the infection and pus formation. Restoring this passage was critical to saving the kidney.

After careful planning, the team performed a complex robotic reconstructive surgery called a Boari Flap Ureteral Reconstruction.

• A part of the urinary bladder was raised as a flap and formed into a tube.
• This bladder flap was then shaped into a new tube to replace the damaged ureter.
• The newly formed tube was connected to the kidney, restoring the natural pathway for urine flow.
  
  

The surgery was performed using a robot-assisted minimally invasive technique, with small keyhole openings, less trauma to the body, less chance of infection, and allowing faster recovery.

Recovery and Outcome

Following the robotic surgery, Mini recovered well under close monitoring. The infection was controlled, the urinary drainage was restored, and she gradually regained stability. She was discharged in stable condition with follow-up care planned to ensure continued healing.

Why Robotic Surgery Was Important in This Case?

If not for the robotic precision, this case would have required a long incision and multiple stitches on the abdomen of the patient, leading to more trauma and pain.

Using the surgical robot, it was possible to carry out this supramajor surgery and operate throughout the abdomen without any incision. There was minimal blood loss. Recovery was faster, and the patient could walk the very next day after the surgery.

The AI-Powered Smart Surgical Robot offers several advantages:

• Enhanced surgical precision
• Magnified 3D vision
• Smaller incisions
• Reduced pain and blood loss
• Faster recovery