21 April 2023
The Department of Urology, Andrology and Robotic Surgery, Fortis Hospital Mohali, has attained significant medical achievement by treating several complex urological diseases using the world’s most advanced 4th Generation Robot – Da Vinci Xi.
The team of doctors led by Dr Rohit Dadhwal, Consultant, Department of Urology, Andrology and Robotic Surgery, Fortis Mohali, recently treated a 72-year-old man suffering from Giant Urinary Bladder Diverticulum (an extremely rare disorder with outpouching/protruding of the normal bladder along with an umbilical hernia) through robot-aided surgery. This is the first-of-its-kind case in the world as per the available medical records. Giant Urinary Bladder Diverticulum can cause complications such as stone formation, urinary tract infection (UTI) and tumours.
The Patient had recurrent urinary tract infections, overflow urinary incontinence, increased frequency and nocturia (condition when one wakes up during the night to urinate). He had undergone multiple prostatic surgeries (at least 5) at various hospitals but his condition failed to improve, following which he approached Dr Dadhwal in February this year.
Medical investigation revealed that the Patient suffered from Giant Urinary Bladder Diverticulum. While the normal capacity of the diverticulum is more than 500 ml, failure to get it emptied during normal urination caused the Patient to have urinary retention, thereby causing recurrent infections.
The team of doctors led by Dr Dadhwal performed Robot-assisted Bladder Diverticulectomy on 23rd February, 2023.Robot-assisted surgery is consideredas the gold standard treatment in such complicated cases situated in the deep pelvis. The Patient had a smooth post-operative recovery and was discharged two days after the surgery on 25th February this year. Post one month of the surgery, he is now completely symptom-free.
In another case, a 35-year-old woman had a single episode of left-sided pain in the abdomen. The ultrasonography revealed a left renal mass. Worried about the progression of the disease, the Patient’s family met Dr Dadhwal in March this year.
Medical evaluation revealed that the Patient had a tumor (4×3 cm) in her left kidney. Considering her age, Dr Dadhwal suggested that Robot-aided surgery would be the appropriate line of treatment.
The Patient underwent Robot-aided Partial Nephrectomy on 25th March recently, wherein only her tumour was removed, while rest of the left kidney (almost 80%) was preserved. Histopathological evidence showed that the tumour had been excised completely. Post-operatively, the Patient was able to walk on the next day of the surgery and discharged on the third day. She has recovered completely and resumed her daily activities.
Discussing the cases, Dr Dadhwal, said, “Robot-aided Surgery is the latest form of minimal invasive surgery and provides a 3D view of the operative field via a special camera inserted into the body of the patient. Parts of the body which are difficult to reach with the human hand can be accessed through robot-assisted arms that can rotate 360 degrees and gives wide range of movements. It neutralizes surgeon’s tremors hence providing maximum precision. With these advantages, Robotic surgery has become the gold standard for the treatment of Kidney and Prostate tumours. Also, it is useful in deep pelvic surgeries like in this case of resection of bladder diverticulum. Moreover, to our knowledge, this is the first case done by robotic surgery for giant bladder diverticulum of more than 500ml capacity, anywhere in the world. All this is made possible with intuitive nature of Da Vinci Robotic technology.”