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A team at Ruby Hall Clinic, led by robotic cancer surgeon Dr Aditya Kulkarni, performed a challenging procedure on a 65-year-old lady to remove a malignant tumour in the rectum as well as gallbladder stones. The surgery was performed with extreme precision using robotic assistance, which ensured complete removal of the tumour and its surrounding lymph nodes. The patient is entirely on the recovery path and has been discharged.
An important part of the procedure was to restore the normal passage of the waste, which is a major cause of concern for most patients. In some cases where the anal sphincter cannot be saved, a permanent opening called stoma has to be made on the abdomen from which the wastes are drained into a bag.
But in this case, Dr Kulkarni said that the upper part of her intestine was connected with the remaining rectum to make a normal passage. A temporary stoma has been made which will be reversed back after six weeks, after which the patient shall pass stools normally. In times of COVID 19, robotic surgery is especially desirable as there is less interpersonal contact and hence decreases the chances of spread of the virus.
Giving details about the case Dr Aditya Kulkarni, Consultant, GI Surgery, Oncosurgery and Robotic Surgery, Ruby Hall Clinic said "This patient came to Ruby Hall in the last week of September with complaints of bleeding and pain while passing the stools. She was suggested CT scan and colonoscopy at some other medical centre, which showed tumour growth and biopsy confirmed it was cancer. When she visited me, it was clear that it was Stage 2 or 3 Cancer and was close to the anus. She was advised to go for chemotherapy and radiation to shrink the tumour. The scan also showed she had stones in her gallbladder."
Dr Kulkarni added "After completion of chemotherapy and radiation, we gave her an option of robotic surgery. Due to the critical location of tumour close to the anus, it was important to ensure that we preserve the anal sphincter. So that she has control over the natural passage of waste and the permanent stoma is avoided. With open surgery, the full clearance of tumour would have been extremely challenging, but due to precise manoeuvring of robotic arms clearance of tumour and surrounding lymph nodes was made easier. The patient's gallbladder along with stones was removed too during the same surgery, which lasted for 5 hours."
Furthermore, the doctor explained that in male patients, this surgery is challenging because of the complicated position of the rectum and narrow pelvis. Many important nerves are present in this area and any injury might have a lasting impact on the patient's life. The magnified three-dimensional vision of robot and movement of robotic arms which is very similar to surgeon's fingers enables precision which leads to fewer nerve injuries, less blood loss during surgery, enables quicker healing and less hospital stay.
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