Omani patient undergoes complex robot-assisted surgery for narrowed ureter of transplanted kidney

Omani woman successfully treated for recurrent UTIs with complex robot-assisted surgery at Fortis Hospital, Bannerghatta Road. Surgery involved removing broken piece of ureteral stent, bypassing blocked portion of urinary tract, and connecting transplanted ureter to bladder. Team of surgeons led by Mohan Keshavamurthy and Sreeharsha Harinatha performed successful procedure.

A complex robot-assisted surgery to clear an obstruction of a narrowed ureter of a transplanted kidney at a private hospital in the city has treated a 51-year-old Omani woman, who was suffering recurrent urinary tract infections.

Doctors at Fortis Hospital, Bannerghatta Road, where the woman was referred to, said she had undergone an unrelated kidney transplant a year ago in Pakistan. The transplanted ureter was obstructed by a broken piece of ureteral stent.

“As part of the transplant, ureteral stenting (also known as double J stent) was done wherein a thin, flexible plastic tube was placed temporarily in the ureter to help urine pass from the kidney into the bladder. The transplanted kidney functioned well, however, a piece of the double J stent in the transplanted ureter was broken,” said a statement from the hospital.

Multiple attempts were made surgically by multiple hospitals in Oman to remove it, however, the broken piece was left behind causing an obstruction to the transplanted ureter and resulting in repeated urinary tract infections.

“In order to provide temporary relief and help preserve kidney function until the underlying issue can be treated, a diversion percutaneous nephrostomy was performed wherein a small tube was inserted directly through the skin and into the kidney, guided by ultrasound.

“The tube was then connected to a catheter outside the body, allowing urine to bypass the blocked portion of the urinary tract and drain directly from the kidney. However, the patient had recurrent urinary tract infection needing multiple courses of IV antibiotics as well as multiple ICU admissions,” the statement said.

The complex surgery was performed by a team of surgeons led by Mohan Keshavamurthy, Senior Director, Urology, Transplant and Robotic Surgery, and Sreeharsha Harinatha, Additional Director, Urology, Transplant and Robotic Surgery, at the hospital.