In a First, doctors at Fortis Hospital, Anandpur successfully treated a 25-year-old Bangladeshi man with a large dumbbell-shaped tumor located behind the pelvis of his abdominal cavity. The tumor’s location posed a challenge due to which team of doctors – Dr. Udipta Ray, Director, GI, General Surgery and Robot-assisted Surgery and Dr. G.R. Vijay Kumar, Director, Neuro Surgery decided to adopt a multi-disciplinary approach via robotic and neurosurgical procedures. which ensured successful removal of the tumor without compromising on the functioning of the vital organs or causing excessive bleeding.
The young patient was troubled by a range of distressing symptoms including persistent back pain, leg pain, tingling, and burning sensations. Additionally, he had been experiencing weakness in his left leg, indicative of a potential neurological issue. In search of better medical care, he traveled from Bangladesh to India. However, post detailed MRI and CT scans, a tumor was detected which originated from the interior of the spinal cord. It further extended into the pelvis through the anterior sacral foramen (portion of the sacrum – a triangular bone at the base of the spine).
Elaborating on the case, Dr. G.R. Vijay Kumar, Director, Neuro Surgery, Fortis Hospital, Anandapur said, “The patient’s symptoms had been progressively deteriorating over the last few months, and scans showed a tumor shaped like a dumbbell with one end in the pelvis, and the other at the back. We decided to completely remove the tumor since these kinds of non-cancerous tumors don’t usually respond well to radiation or chemotherapy. The challenge was operating on the tumor since it was surrounded by important organs in the pelvis as well as the spinal cord. To tackle this complexity, we split the surgery into two parts – while one part focused on the spinal section, the other dealt with the pelvis. Dr. Ray employed robot assistance to help with the tricky pelvic area. The surgery needed careful dissection/cut and removal of the entire tumor, using special sponges to control bleeding. He also placed a marker to guide the second part of the surgery from the back.”
Dr. Udipta Ray, Director, GI, General Surgery and Robot-assisted Surgery, Fortis Hospital, Anandapur said, “The tumor’s distinctive location posed risks to critical organs, nerves, and blood vessels. To address these challenges, we adopted a meticulously planned two-phase approach. Therefore, in the initial phase, we employed robotic technology for precision and to minimize blood loss. This segment focused on the abdominal side of the tumor, demanding extra care due to its proximity to vital organs including ureter, iliac vessels, and rectum. In the second phase, the patient underwent a neurosurgical procedure. The patient was positioned on his stomach; Dr. Vijay utilized this approach to successfully remove the remaining portion of the dumbbell shaped tumor from the spinal cord.”
Mr. Ashish Mukherjee, Facility Director said, “We are proud of our medical team’s groundbreaking accomplishment in the first-ever multidisciplinary robot-assisted removal of a neurogenic tumor from the pelvis. This exceptional achievement shows our commitment to using advanced and patient-focused healthcare. It also highlights our commitment to finding new and innovative solutions for complicated medical situations and has been submitted for consideration in clinical awards.”
The uniqueness of this case lies in the innovative combination of robotic surgery and neurosurgery, a first in eastern India. The patient, post-surgery, experienced relief from the burning sensation and is recovering well. While he had some residual weakness in the lower limb, he responded positively to physiotherapy. The success of the procedure highlights the precision and advantages offered by robotic technology in tackling challenging and delicate cases like this one.
