12-year-old suffering from congenital condition was advised to get his kidney removed. Fortis doctors came to his rescue by repairing the problem through an advanced technique and avoided removal of damaged kidney
Bengaluru: When Tanish Guin’s parents took him for a routine medical check-up as part of a school admission process, little did they know that the results would leave them shattered.
The family from Murshidabad, about 230 kms from Kolkata, could not come to terms with the fact that the 12-year-old was suffering from a congenital condition that was damaging his kidneys. They received another shocker, when doctors whom they consulted in Kolkata told them that the only solution was neprectomy (removal of one of the kidneys).
Desperate, they travelled all the way to Fortis Hospitals, Bangalore and their prayers were answered as the urology team at Fortis ruled out kidney removal and conducted a complex procedure called Laparoscopic Pyeloplasty to correct the problem.
THE DIAGNOSIS
“As part of the medical check up, the family doctor did a physical examination and found a lump in the lower part of the left abdomen. Ultrasound tests revealed that both the right and left kidneys were not functioning properly. We rushed Tannish to a private hospital in Kolkata and were shocked when the doctor said that his kidney needs to be removed. We were really disturbed about our son’s health and wanted to look at other alternatives,” says Tanish’s father, who works in a bank in Murshidabad.
The worried father searched the net for possible solutions and came across Fortis Bangalore and Dr Keshavamurthy as one of the best urologists in India. They saw a flicker of hope and immediately brought the child here.
“When they came to us, Tanish and his parents were extremely apprehensive and worried as they did not want his kidney to be removed. We conducted various tests including a DTPA scan, a test used to check function of kidneys as well as find out if the problem is related to the obstruction of the urine flow in the ureters / bladder. Tanish was diagnosed with bilateral PUJ (Pelviureteric junction) Obstruction present at birth, a condition which affects urine flow and is caused when there is a narrowing of area between the ureter (the tube that drains urine from the kidney to the bladder) and the part of the kidney called the renal pelvis. Urine can build up and damage the kidney as a result). This condition is seen in about 1 in 50 children,” explained Dr Mohan Keshavamurthy, Consultant Urologist and Transplant Surgeon at Fortis Hospitals.
TREATMENT
Dr Keshavamurthy assured Tanish’s parents that his kidney would be saved and an operation to remove the obstruction and restore urine flow would be done. In June, the urology team led by the doctor performed the first of a two part surgery.
“Tannish’s left kidney was severely damaged and his renal function had dropped to just three per cent. The right kidney was also compromised but not as much as the left. We performed a minimally invasive reconstructive procedure known as Laparoscopic Pyeloplasty on the left side and put a stent at the site to drain urine from the kidney until the surgery heals. In a few weeks, the kidney function improved to 12 per cent and is slated to improve even further. In August, left stent was removed and Laparoscopic Right Pyeloplasty was performed. The boy has recovered remarkably and once he is well, he can take part in any physical activities including playing a sport,” he added.
Laparoscopic Pyeloplasty is an effective way to correct narrowing or scarring where the ureter (the tube that drains urine from the kidney to the bladder) attaches to the kidney through a minimally invasive procedure. Endoscopic technique does not require a surgical cut on the skin. Instead, a small instrument is placed into the urethra. This allows the surgeon to open the blockage from the inside. Scar tissue is removed from the blocked area and the healthy part of the kidney is connected to the healthy ureter.
According to Dr Keshavamurthy, this is a complex procedure done in very few centres in India needs expertise and advanced medical infrastructure. Compared to conventional open surgery, laparoscopic pyeloplasty results in less post-operative pain, a shorter hospital stay, earlier return to daily activities.
For Tannish’s parents, the procedure and care at Fortis seems like a godsend. “I want to go back home and play with my friends as I am feeling fully alright,” says Tanish.
