Doctors at Fortis Hospital, Cunningham Road applied the unique Supine PCNL (Percutaneous Nephrolithotripsy) to successfully treat a patient with a large stone in a Sagittally malrotated kidney; a rare congenital anomaly. This patient’s condition is rare as it is only one among ten reported cases in the world. This is the first time that this unique technique was used in India to treat this condition. The team was led by Dr Shakir Tabrez, Senior Consultant, Urology, Uro-oncology, Andrology, Transplant & Robotic Surgery and Dr Mohan BA, Consultant, Urology & Transplant surgery at Fortis Hospital, Cunningham Road.
The procedure was conducted on a 51-year-old lady with a 2 cm large stone in the right kidney – malrotated in sagittal plane (long axis of kidney in the horizontal plane). Supine PCNL is a new approach for removal of kidney stones with enhanced clinical outcomes. It is useful for performing stone removal surgeries in obese and high risk patients. It also obviates the need for tenuous prone Anaesthesia for prolonged periods in such patients.
Talking about the case, Dr Shakir Tabrez, Senior Consultant, Urology, Uro-oncology, Andrology, Transplant & Robotic Surgery, Fortis Hospital, Cunningham Road said, “This was a rare case and we had decided to work with the new approach, considering the complexity of the case. The PCNL procedure was done in the supine position (with the patient lying with his chest facing upwards), hence termed Supine PCNL. We have utilised ultrasound and fluoroscopy guidance to access the kidney. Stone fragmentation and complete suction and evacuation was done using Shockwave Pulse Equipment giving complete stone clearance.”
Dr. Mohan BA, Consultant, Urology & Transplant surgery at Fortis Hospital, Cunningham Road, added “This patient was obese with comorbidities and a rare kidney anomaly. Using supine PCNL technique we were able to remove her stone with minimal invasive technique within one hour of operative time and less than 48 hours hospital stay”.