Alexia Penna
An unprecedented case of robotic surgery was carried out at the Molinette hospital in Turin, where a 29-year-old boy suffering from high-risk bladder cancer underwent a minimally invasive operation that allowed the diseased bladder to be removed and one of two non-functioning transplanted kidneys and rebuilding a new bladder with part of the intestine.
The patient had already undergone a kidney transplant twice, once in another Italian region and the other in Turin in 2020, thanks to the mother’s donation. A few months after the second transplant, however, he had been diagnosed with bladder cancer, which required a radical solution.
Thanks to robotic surgery, an advanced technique that allows the surgeon to operate remotely with a three-dimensional vision and greater movement precision, it was possible to perform the operation with minimal invasiveness and a reduction in hospitalization and recovery times.
This is an exceptional result, never obtained before in medical literature, which demonstrates the potential of robotic surgery applied to gynecology and urology, and which offers the patient a better quality of life.
“The complexity of the intervention – said Professor Paolo Gontero (Director of the Molinette University Urological Clinic) – lay above all in having to find the right compromise between the need to carry out a very demolitive intervention and at the same time the need to preserve maximizing the patient’s quality of life by reconstructing the bladder, in order to avoid an external stoma and sparing the structures assigned to the sexual function, considering the young age of the patient himself”.
The decision to use the robotic technique came about after a careful evaluation by the urological teams and by that of the Kidney Transplant Center which is treating the patient.
The operation made it possible to achieve the pre-established objective of removing the bladder, the native ureters in a single block, one of which with a small malformed kidney from birth, the lymph nodes of the pelvis and the non-functioning transplanted kidney, as well as realizing the reconstruction of a neobladder using 45 cm of intestine.
“We clearly perceived the advantages of minimally invasive robotic surgery not only in the demolition part – Gontero explained again -, especially when it was a question of removing the non-functioning transplanted kidney where there were tenacious adhesions, but also in the phase of restoring the connection of the functioning transplanted kidney to the neobladder, a step that would have been extremely complex in traditional surgery”.
Great care was taken to preserve the functioning transplanted kidney donated by the mother. The postoperative course, carried out at Professor Luigi Biancone’s Nephrology, usually not without complications in cystectomy operations, was extremely regular and characterized by a rapid recovery, confirming the advantages of minimally invasive surgery.