Visakhapatnam's first robotic Boari flap surgery restores kidney function
The Asian Institute of Nephrology & Urology (AINU), Visakhapatnam, has successfully performed the city’s first robotic Boari flap reconstruction surgery to treat a complex long-segment ureteric stricture, restoring normal kidney function in a 50-year-old woman. The patient, a resident of Kakinada, had been suffering from a ureteric stone that could not be treated successfully at another hospital due to significant narrowing of the ureter. Her condition led to urinary obstruction and infection, requiring immediate medical intervention.
Upon admission at AINU Hospital Vizag, the medical team stabilised her condition by placing a percutaneous nephrostomy (PCN) tube to relieve the obstruction. The stone was then successfully removed. However, the patient continued to experience recurrent infections due to a long segment ureteric stricture, which left her dependent on an external drainage system. After a thorough evaluation, the urology team opted for a robotic reconstructive approach to restore normal urinary flow and preserve kidney function.
Dr. Amit Saple, Senior Consultant Urologist, Transplant, Laparoscopic and Robotic Surgeon, explained: “This was a highly complex reconstructive case. The ureteric narrowing involved a long segment located close to major pelvic blood vessels, making the surgery technically demanding. Robotic technology allowed us to perform the reconstruction with exceptional precision while minimising surgical trauma, resulting in quicker recovery and excellent outcomes.”
During the surgery, the team encountered a more extensive ureteric defect than anticipated, making conventional procedures unsuitable. The surgeons performed a robotic Boari flap reconstruction, a specialised technique in which a flap from the urinary bladder is used to reconstruct the damaged ureter. The procedure was carried out using minimally invasive robotic technology through just a few keyhole incisions. This approach resulted in minimal blood loss, reduced postoperative pain, faster recovery, and excellent functional outcomes.
The patient recovered well, had the kidney tube removed prior to discharge, and was discharged within three days. A ureteric stricture is an abnormal narrowing of the ureter, the tube that carries urine from the kidney to the bladder. It can be caused by stones, infections, or prior surgeries. If left untreated, it can lead to kidney damage. Traditionally, such repairs required open surgery with large incisions and longer hospital stays. Robotic surgery offers greater precision and less invasiveness, making it particularly beneficial for complex reconstructions.
AINU Visakhapatnam has established itself as a centre for advanced urological care in the region. This milestone highlights the availability of state-of-the-art robotic technology in Vizag, reducing the need for patients to travel to larger metropolitan cities for complex procedures. The success of this surgery underscores the importance of timely intervention and the evolving capabilities of healthcare in Andhra Pradesh.
