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Robotic Surgery on the bile ducts in a child, a first in India done at Apollo Chennai

Date: 18 Nov 2014

The condition called choledochal cyst was something that she was born with (congenital) but which became progressively worse as she grew older. The family said it was truly horrifying to witness the episodes of pain, which were truly unbearable, and begged to provide relief.

The treatment for this condition is surgery. The abnormal ducts need to be removed and a new pathway had to be created for the bile to reach the intestine. Bile is essential for fat digestion and absence of bile will lead to jaundice and frothy stools with poor weight gain and loss of appetite. Also with increasing age cancer in the abnormally dilated ducts is a distinct possibility. For several reasons surgery was urgently indicated. Firstly however Dr. Dhanasekhar Kesavelu (Pediatric Gastroenterologist) stabilized liver function and ensured fitness for surgery.

The traditional approach by open surgery involves making a large cut below the right rib cage, pushing away the intestines, pulling up the liver, cutting out the dilated bile ducts and ensuring that drainage is re-established. When this was explained the father of the child asked us if we would consider a minimally invasive option which would give the child no scars, less pain and an early recovery.

At Apollo Hospitals Dr. V. Sripathi (pediatric robotic surgeon) offered to use the Da Vinci Si robot to do this major surgery. Four small holes were made and a telescope with 3D vision was introduced. The magnification of ten times provided by the robot gave a tremendous in-depth view of the dilated ducts leading down from the liver. Using the miniature instruments on the robotic arms and with minimal disturbance to the surrounding tissues the enlarged and diseased bile ducts were carefully separated and removed. Coring out the dilated ducts from inside the pancreas was precisely and meticulously done. Once it was confirmed that all diseased tissue had been removed the remaining stump of normal bile duct was joined to the duodenum (first part of the intestine). The child's recovery was remarkable. Sharmitha is now attending school, is pain free, eating normally and gaining weight. With the assistance of the Da Vinci Si robot a major surgery on the bile ducts has been accomplished at Apollo Hospitals with minimal morbidity. This represents a landmark event in children's surgery. Dr Sripathi has now completed more than 50 such major surgeries in children and has the largest single experience in the country.

Our Chairman Dr Pratap C Reddy has always believed in offering the best of care that is also most affordable. In keeping with this promise, robotic surgery in children is well within the range of the common man. If you need further details call 28296316 to fix up and appointment with Dr Sripathi.

 
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