The kidneys of a 45-year-old woman from Kompally, Hyderabad, were fused and pancake-shaped rather than bean-like due to a rare congenital condition. Additionally, the kidneys were positioned far below where they should have been. She nevertheless endured this condition for forty-five years. These fused kidneys recently developed a malignant tumor. Pancake kidneys are a rare condition that only occurs in 1 in 375,000 cases worldwide, according to estimates. Even rarer is a tumor in such an abnormal kidney.
These fused kidneys are known as lump kidneys in medicine, and they are referred to as ectopic kidneys when they are found in an abnormal location. Because of their complex anatomy and complicated blood supply, tumor mapping is difficult in these situations. Using 3D imaging technology, a breakthrough was made at the Asian Institute of Nephrology and Urology (AINU). The patient’s CT scan was combined with specialized software to produce a 3D model that gave important information about the location of the tumor, the anatomy of the fused kidneys, and their blood supply.
Dr. S.M. Ghouse, Director of the Robotic and Uro-Oncology Department at AINU, shared, “When the patient came to us, tests revealed the presence of a cancerous tumor. The CT scan showed a highly complex structure with fused kidneys, abnormally located in the pelvis. Identifying the exact location and relation of the tumor to the surrounding vital structures in such cases is extremely difficult. Hence, we opted for 3D modeling, which gave us insights for pre-surgical planning significantly, particularly for keyhole surgeries. Typically, cancerous tumors in kidneys often require the removal of part of the kidney or the kidney itself. However, given the rare anatomy in this case and the delicate blood supply, we decided to perform minimally invasive keyhole surgery using advanced technology.”
Under the leadership of AINU’s Managing Director, Dr. C. Mallikarjuna, a dedicated team embarked on this rare and complex surgical procedure. Uro-oncologist Dr. Rajesh played a vital role in the surgery. Utilizing the 3D model, the team was able to precisely plan and remove the tumor through just tiny incisions. This ensured minimal blood loss, and the patient was discharged within three days, having fully recovered.
First-of-its-kind Surgery
This case marks a historic achievement. Until now, in literature, tumors in pancake kidneys have been removed only through open surgery. This is the first time keyhole surgery has been performed successfully in such a case. “This accomplishment was possible only because of the combination of advanced technology and the expertise of our team. The use of 3D modeling was a significant boon, allowing us to overcome multiple challenges and perform the surgery with precision,” explained Dr. Ghouse.
Dr. Mallikarjuna, Managing Director, AINU, added, “At AINU, our sole aim is to push the boundaries of what is possible in urology and oncology. This success reflects our team’s dedication, expertise, and capability to handle even the most complex cases with precision and care.”
