Keyhole surgery performed on 3 month-old-child with kidney blockage
Hydronephrosis is a common issue detected during pregnancy scanning, often presenting as a mild condition called ‘transient hydronephrosis’.
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CHENNAI: A successful keyhole surgery was performed on a 3-month-old infant with a serious blockage in the right kidney at a private hospital in the city. Asian Institute of Nephrology and Urology performed the surgery on a baby who was diagnosed by 'severe hydronephrosis’ - a condition characterized by kidney swelling due to urine stagnation.
Hydronephrosis is a common issue detected during pregnancy scanning, often presenting as a mild condition called ‘transient hydronephrosis’.
In some cases, it can lead to a serious blockage and pose a threat to the overall kidney function.
After the diagnosis, the baby was recommended a crucial keyhole surgery known as Laparoscopic Pyeloplasty for complete recovery. In the case of the infant, the parents were already aware of the foetal right kidney swelling even before birth.
It was only after the baby was born and further tests were conducted, they realized the severity of the condition. The kidney was found in an abnormal site, situated lower than the normal position near the bladder.
This had not only changed the structure of the kidney but also led to urine stagnation that disrupted the kidney functioning upto 50 percent. Dr Ramesh Babu, paediatric urologist at the hospital evaluated the infant's condition, along with the position of the kidney and the level of blockage through a diagnostic procedure called Retrograde Pyelography (RGP).
Dr Ramesh Babu explained that opting for a minimally invasive surgery on an infant and managing a pelvic ureteric junction obstruction in a pelvic malrotated kidney is a significant challenge. Although robotic surgery is also available at AINU, we opted for the laparoscopic approach due to the infant's tiny abdomen size.
"In cases where both kidneys are swollen, indicating a serious valve blockage below the bladder, immediate endoscopic treatment is crucial right after birth. A condition called reflux, where urine flows backward from the bladder to the kidneys, may necessitate laparoscopic or robotic reimplantation. Milder types of reflux can be cured by an endoscopic injection treatment," he said.
Subsequently, a successful keyhole surgery - laparoscopic pyeloplasty, was performed using 3mm instruments to clear the blockage. The baby recovered fully within two days and got discharged on the third.
