Lucknow: In a groundbreaking medical achievement, doctors at Dr Ram Manohar Lohia Institute of Medical Sciences (RMLIMS) have successfully performed a fully robotic surgery for a rare and complex kidney cancer involving a major abdominal vein. The procedure was carried out on a 40-year-old woman from Gorakhpur who had a large tumor in her left kidney along with a Level II tumor thrombus — a condition in which the cancer forms a clot-like growth inside a vein — extending into the inferior vena cava (IVC), the body's largest vein that carries blood from the lower body to the heart.
Challenging Case Due to Rare Anomaly
The case was particularly challenging because of a rare congenital anomaly called a retroaortic left renal vein, where the kidney's main vein passes behind the aorta (the body's main artery) instead of in front of it. This variation is seen in only 1%-2% of people worldwide and makes surgery complicated. The tumor clot had extended up to veins near the liver, further increasing the risk.
Around 10% of kidney cancer patients develop tumor thrombus in the IVC, but most such cases occur on the right side due to anatomical reasons. Left-sided cases are less common. Cases involving this rare vein anomaly are uncommon, with only five reported worldwide, and earlier surgeries were done through open procedures requiring large incisions.
First Fully Robotic Management
The RMLIMS team claimed to be the first to manage such a case using a completely robotic approach — a minimally invasive technique in which surgeons operate using robotic instruments through small cuts, allowing precision and faster recovery. The five-hour surgery was performed by a team led by Prof Alok Srivastava, along with Prof Ishwar Ram Dhayal and Prof Sanjeet Singh. The patient was discharged on Monday.
The cost of the procedure at the government institute was around Rs 1.3 lakh, significantly lower than Rs 7-8 lakh typically charged in private hospitals. Director Prof CM Singh congratulated the team and said it was among the most challenging urological surgeries and required coordinated work by multiple specialists.
