Image Credit: Supplied

A two-month-old baby girl, residing in the UAE with her family, underwent a successful minimally invasive mini-laparoscopic pyeloplasty at the surgical institute of Fakeeh University Hospital, Dubai Silicon Oasis.

The baby suffered from complete pelvi-ureteric junction (PUJ) obstruction, a narrowing in the proximal part of the ureter that drains urine from the kidney, which may progressively impair kidney function. She also experienced bouts of excessive crying, which parents often attribute to hunger, in addition to feed intolerance that made her throw up.

The parents were aware of the birth defect in their daughter and had been seeking treatment options. They were disheartened when the only option offered was open surgery. The thought of their little one undergoing a major surgery was daunting. Continuing to seek a solution, the parents did some online and offline research, which led them to Fakeeh University Hospital, located in Dubai Silicon Oasis. They met with Dr Kamalesh Pal, Consultant Paediatric Surgeon and Paediatric Urologist, who specialises in management of such cases in newborns, infants and children.

Within two weeks of the consultation and after a proper evaluation, Dr Pal conducted a minimally invasive mini-laparoscopic pyeloplasty surgery. This included surgical correction of the block and insertion of a ureteric stent to favour the drain of urine, relieving the swollen kidney.

Dr Kamalesh Pal, Consultant Paediatric Surgeon and Paediatric Urologist

“The congenital defect the baby suffered from caused severe swelling in both kidneys, resulting in critically low functioning of the left kidney,” explains Dr Pal. “The condition is due to an abnormality in development of nerve and muscles in the area. Early detection and intervention are warranted to save the kidney function. An extensive open surgery is still an option in some cases, however, if the surgeon is well trained and skilled enough to manage the condition, laparoscopic methods are the way to go.”

The post-operative period was smooth for the baby. She was on minimal pain medications and began to feed normally, three hours post-surgery.

What makes this a rather unique case is the rapid deterioration in kidney function within two months of birth. The surgical space is extremely limited, given the size of the baby for the laparoscopic manoeuvres, hence requires utmost skill and precision. It was a delicate surgery to perform as it needs fine suturing, since it is performed laparoscopically with only three 3mm incisions (one being the belly button). The surgery can only be performed by a highly experienced paediatric surgeon, with the help of state-of-the-art minimally invasive technology and equipment. This showcases the excellent combination of care based on technology, academic-driven approach, and healing environment at Fakeeh University Hospital, which aids to precise diagnosis and faster recovery.