45-year-old woman undergoes right laparoscopic partial nephrectomy

Mysuru: Renal Angiomyolipoma (AML) is a tumour in the kidney composed of blood vessels (angio-), smooth muscle (myo-) and fat (lipoma). These tumours are mostly non-cancerous but if they grow large or are left untreated, they can cause complications such as profuse bleeding from the kidney, which may require removal of kidney.

Addressing a press meet at Patrakarthara Bhavan in city on Dec. 3, Dr. K.A. Thimmaiah, Consultant – Urologist, Manipal Hospital, Mysuru, shed light on a complicated case of renal (kidney) tumour surgery at Manipal Hospital.

The Patient’s Journey

The 45-year-old woman Prema (name changed) presented with recurrent UTI and was treated for the same. During her next visit as part of the work up, she was incidentally diagnosed to have right renal Angiomyolipoma which had grown significantly, measuring 6.7×6.5×6 cm and her present symptom was not related to this diagnosis.

Speaking about this situation, the renowned Urologist Dr. Thimmaiah stated, “While Angiomyolipomas though benign, but increase in their growth can lead to severe complications such as spontaneous bleeding. The mass can rupture, leading to a life-threatening condition requiring emergency surgery. If left unchecked, it can even result in the loss of the kidney, as surgeons may need to remove the entire organ to stop the bleeding.”

Comprehensive Diagnosis, Challenging Treatment

Upon establishing the diagnosis of right renal Angiomyolipoma, the medical team led by Dr. Thimmaiah determined that the best course of action would be to perform a right laparoscopic partial nephrectomy (removal of the affected part of the kidney).

Laparoscopic surgery is a minimally invasive procedure that allows for the removal of the tumour while preserving the kidney. However, in many cases, despite laparoscopic surgery being minimally invasive, conventional open surgery may have to be considered due to certain challenges (as in this case especially as the tumour size was large).

Dr. Thimmaiah explains, “The kidney is highly vascular and has a rich blood supply. This poses a high risk of bleeding, especially when separating the tumour from the kidney. The large size of the tumour further adds to the complications. Conversion of the laparoscopic surgery to open surgery may be required to separate the tumour from the kidney and also achieve optimal bleeding control.”

With Dr. Thimmaiah’s expertise and surgical skills, the challenges were navigated successfully without the need for open surgery or any other major complications.

Following the surgery, the patient’s recovery was swift, and she was discharged with stable vital signs, with post-operative care plan that included antibiotics, pain management, and instructions for follow-up.

Promise of Advanced Surgical Technologies

The successful outcome of this complex surgery reinforces the promise of advanced surgical technologies and the clinical expertise available at Manipal Hospital, Mysuru.

“This case highlights the importance of advanced surgical techniques. We were able to perform a delicate surgery with precision, bypassing the need for open surgery and preventing complications such as need for complete removal of the kidney,” said Dr. Thimmaiah.