Rare pancake kidney tumour removed via keyhole surgery at Hyderabad AINU

Hyderabad: A 45-year-old woman from Kompally was successfully operated upon at AINU for a rare congenital condition of the kidneys.

Due to her condition, her kidneys were fused and pancake-shaped, instead of the usual bean-like structure. Moreover, the kidneys were positioned abnormally lower than their usual location. Despite this, she lived with this condition for 45 years. Recently, a cancerous tumour developed in these fused kidneys. The occurrence of pancake kidneys itself is a rarity estimated to be seen in only 1 in 375,000 cases globally. A tumour in such an anomalous kidney is even more rare.

What is the rare condition of the kidneys?

Such fused kidneys are medically termed lump kidneys, and when located abnormally, they are called ectopic kidneys. Mapping tumours in such cases is challenging due to the complexity of blood supply and their intricate anatomy.

At the Asian Institute of Nephrology and Urology (AINU), a breakthrough was achieved using 3D imaging technology. A CT scan of the patient was integrated with specialized software to create a 3D model, which provided critical insights into the anatomy of the fused kidneys, their blood supply, and the tumour’s location.

Dr SM Ghouse, director of the Robotic and Uro-Oncology Department at AINU, shared details about this unique case.

“When the patient came to us, tests revealed the presence of a cancerous tumour. The CT scan showed a highly complex structure with fused kidneys, abnormally located in the pelvis. Identifying the exact location and relation of the tumour to the surrounding vital structures in such cases is extremely difficult. Hence, we opted for 3D modelling, which gave us insights into pre-surgical planning significantly, particularly for keyhole surgeries. Typically, cancerous tumours in kidneys often require the removal of part of the kidney or the kidney itself. However, given the rare anatomy in this case and the delicate blood supply, we decided to perform minimally invasive keyhole surgery using advanced technology.”

Minimal blood loss and speedy recovery

Under the leadership of AINU’s Managing Director, Dr C Mallikarjuna, a dedicated team embarked on this rare and complex surgical procedure. Seasoned uro-oncologist Dr Rajesh played a vital role in the surgery. Utilizing the 3D model, the team was able to precisely plan and remove the tumour through just tiny incisions. This ensured minimal blood loss, and the patient was discharged within three days, having fully recovered.

First-of-its-kind surgery

This case marks a historic achievement. Until now, in literature, tumours in pancake kidneys have been removed only through open surgery. This is the first time keyhole surgery has been performed successfully in such a case.

“This accomplishment was possible only because of the combination of advanced technology and the expertise of our team. The use of 3D modelling was a significant boon, allowing us to overcome multiple challenges and perform the surgery with precision,” explained Dr Ghouse.

Dr Mallikarjuna, managing director of AINU, added, “At AINU, our sole aim is to push the boundaries of what is possible in urology and oncology. This success reflects our team's dedication, expertise, and capability to handle even the most complex cases with precision and care.”