Robotic excision of tumour in child carried out at Delhi’s Ganga Ram Hospital

The hospital said it was the first time a successful robotic surgery was conducted on a child to remove a tumour. The child was found to have a large eight centimetre tumour in the left adrenal gland.

Sir Ganga Ram Hospital on Tuesday said it had carried out the country’s first successful robotic surgery on a child to remove a tumour of from an adrenal gland that was causing very high blood pressure and other medical problems.

Breast Cancer Awareness Ribbons (Getty Images)

“To the best of our knowledge, it is the first such reported case of robotic pheochromocytoma (large tumour) excision in pediatric age group in India,” said the hospital in a statement after the 14-year-old-child was doing well after three-week’s of follow up.

The child, who had reported of sweating, palpitations, breathlessness and high blood pressure, was found to have a large eight centimetre tumour in left adrenal gland, along with high hormone levels, suggestive of pheochromocytoma.

The adrenal gland is a deep-seated gland in the abdominal cavity above kidney, adjacent to biggest blood vessels and important organs of the body. It is usually removed by open surgery, which entails a big cut and long recovery.

“The location and size of tumour, its proximity to vital organs like pancreas and major blood vessels, coupled with small abdominal cavity in a child made it very challenging and robotic platform was chosen to overcome these problems,” said robotic surgeon Vivek Bindal.

Another challenge was to maintain blood pressure before, during and after surgery.

“This rare tumour required meticulous preoperative preparation,” said Jayashree Sood, chairperson, department of anesthesia. Even minimal manipulation of adrenal tumour during surgery can shoot the blood pressure to alarming levels, while it falls precipitiously immediately after removal of tumour, she said.

The tumour was removed in totality (otherwise it could have turned out to be cancerous) without any significant blood loss. The child was kept in hospital for four days and thereafter was discharged without any blood pressure medication

Satish Aggarwal from department of pediatric surgery said: “This was a very challenging case to manage because of wide variations in blood pressure, precarious location of tumour and low reserve in children.”