KOCHI: In a first in the country, doctors at a hospital in the city successfully performed appendix substitution of ureter by using 3D laparoscopic technology on a 42-year-old man. Only four such cases have been reported in the world so far, claimed the hospital authorities.
According to the doctors, the patient Peter from Thrissur who was suffering from lower abdominal pain on his right side, came to them after treatment at different hospitals failed to provide him any relief. In an MRI scan conducted in the hospital, a tumour, which had a size of around 3 to 4 cm, was detected in his right ureter, the tube which connects kidney to the urinary bladder. The tumour caused obstruction in the patient's right kidney.
"The patient was left with the option of either removing the whole right kidney along with the tube or save the right kidney by cutting around 4 cm of the ureter along with the tumour," said Dr George P Abraham, chief urology surgeon, VPS Lakeshore, who led the surgery.
With the help of 3D laparoscopy, doctors removed about 5cm of ureter along with the tumour. The upper and lower part of the ureter could not be joined together due to the large gap created after the removal of the tumour. "A new tube reconstruction using the bladder tissue was not possible since all the abdominal contents were stuck together. So we decided to bridge the gap using the appendix, a thin tubular structure. The appendix is almost the same size as of the ureter," said Dr George P Abraham.
The doctor added that the appendix was separated from the intestine along with its blood supply and connected to the ureter laparoscopically bridging the gap and establishing continuous urine flow
from the right kidney. The patient recovered well following the procedure and was discharged on the fourth day. Doctors said that the appendix, which usually doesn't have any function in the body, can be used for such substitutions thus salvaging the kidney.
The medical team comprised Dr Datson George P, Dr Vijay and anesthesia chief Dr Mohan Mathew.