Amrita Hospital Doctors perform first Robot-Assisted Surgery for rare colon tumour in 67-year-old Uzbekistan man

Faridabad: In a groundbreaking surgical feat, a 67-year-old man from Uzbekistan was treated for his rare colonic tumour at Amrita Hospital, Faridabad marking the world's first robot-assisted surgery for the condition. 

The patient, from Uzbekistan, had a special condition where his liver and colon were positioned differently (situs inversus partial) and he had a malignant tumour in this mispositioned colon.

The tumour was found to be a rare variant of colonic malignancy. The urgency of the surgery for the patient was high due to the tumor causing an obstruction in his large intestine, preventing him from eating solid foods, and posing a risk of spread and complications.

The surgery, which lasted about six hours, was performed by the Department of Gastrointestinal Surgery at Amrita Hospital, Faridabad. The surgery was led by Abhishek Agrawal and his team included Prof. Puneet Dhar, and Dr. Saleem Naik.

The robotic instruments used can bend and rotate with far greater dexterity than the human hand, enabling complex and precise movements. Additionally, these systems include tremor filtration technology, which eliminated the natural hand tremors of the surgeon, resulting in steadier and more controlled actions. These capabilities collectively contribute to more accurate targeting and removal of tumors, preservation of healthy tissues, and overall improved surgical outcomes.”

Situs inversus partial is quite rare, with overall incidence (including both totalis and partial) being approximately 1 in 10,000 people. However, partial forms are less frequently reported, and precise incidence rates for partial situs inversus specifically are not well-documented due to its rarity and variability. Situs inversus partial, where some internal organs are mirrored, is often genetic and may involve mutations or autosomal recessive traits.

Untreated, it can lead to misdiagnosis and delayed treatment of acute conditions like appendicitis, potentially life-threatening if not promptly addressed. Associated congenital anomalies can cause functional issues, and gastrointestinal problems, such as increased risk of bowel obstruction or volvulus, may arise, particularly with organs like a right-sided sigmoid colon.

Dr Puneet Dhar, HoD, Gastrointestinal Surgery, Amrita Hospital, Faridabad said, “The surgery was particularly challenging due to the anatomical variation in the patient, necessitating modifications in both patient positioning and the positioning and docking of the robotic instruments to successfully reach and remove the tumor. Despite these complexities, the patient had a successful surgery and subsequent recovery.

He was kept under observation in intensive care and was shifted to a general bed the day after the surgery. By the third day, he was able to resume a normal diet and was discharged just a week after the procedure.”

“Based on the final biopsy report, the patient will need to undergo chemotherapy. After completing the treatment, he will only require routine blood tests and imaging for surveillance to detect any early recurrence and receive timely treatment. They can continue with their normal life without the need for long-term medications or restrictions,” said Dr Saleem Naik, Senior Consultant, GI Surgery, Amrita Hospital, Faridabad.

The patient had been suffering from intestinal obstruction due to the tumor for the past two months, which rendered him unable to eat and caused significant weight loss. His symptoms included vomiting, inability to eat, weight loss, anemia, and abdominal distension, leading to his admission to the hospital.

The patient said, “I am incredibly grateful to the team at Amrita Hospital for their exceptional care. The robot-assisted surgery not only relieved my symptoms but also improved my quality of life significantly. I can now eat normally and live without the constant pain and discomfort that I was experiencing.”

Robot-assisted surgery shortens hospital stays and accelerates recovery through smaller incisions, reduced pain, and lower infection risk. Enhanced precision allows effective and targeted interventions, facilitating quicker healing. Safety measures include rigorous training for surgeons, multiple system checks, and continuous monitoring of patient vitals and robot performance. Surgeons retain full control of the instruments, with the ability to override the system if necessary. These protocols ensure the effectiveness and reliability of robotic surgery, leading to improved patient outcomes and more efficient recovery processes.