• The surgery led by Dr. Ashwinikumar Kudari was done with the help of a new-age surgical robot, da Vinci

Doctors at Narayana Health, one of the leading multispecialty hospitals in Bengaluru, performed a unique robotic-assisted surgery to save a 60-year-old woman who had a complicated tumour in the pancreas. The surgery was led by Dr. Ashwinikumar Kudari, a renowned Robotic Surgeon and Surgical Gastroenterologist, with the help of one of the new-age robotic-assisted surgery systems, the da Vinci by Intuitive. Dr. Jayant Mulchandani and Dr. Mohammed Shies Sadat were also a part of the expert team who carried out this surgery.

The patient arrived at Narayana Health Hospital with severe abdominal pain, and previous Contrast MRI revealed a periampullary tumor in her pancreas, raising concerns about the potential need for a complicated Whipple procedure. The PET CT scan performed at NH also suggested a likely malignant lesion. But, as there was no direct evidence of malignancy, Dr. Kudari decided to perform a robotic-assisted ampullectomy followed by a frozen biopsy to confirm whether it was malignant or not. The result of frozen biopsy came within 30 minutes, displaying a rare Intra ampullary papillary tubular neoplasm with no dysplasi or invasive malignancy.

Based on this diagnosis, Dr. Kudari and his team decided to go ahead with robotic-assisted ampullectomy, avoiding the complex Whipple procedure that has a very high morbidity and about 5% mortality rate.

Dr. Ashwinikumar Kudari, who led this procedure, said, “Performing country’s first-ever robotic-assisted ampullectomy is a remarkable achievement in the field of surgical gastroenterology in India. This procedure not only offers a minimally invasive approach, but also highlights the potential of robotic surgery technology in transforming the way we treat periampullary tumors. I am proud of our team’s relentless pursuit of innovation and their unwavering dedication in delivering exceptional patient outcome.”

While talking about the procedure, Dr. Kudari added that “Ampullectomy is a highly complex procedure involving the removal of the ampulla of Vater, a critical structure located at the junction of the common bile duct and the pancreatic duct. This delicate operation is traditionally performed by open method with large incisions, and it comes with post-surgical complications such as infection and pain. But, now, with advanced surgical technologies like da Vinci 4^th generation RAS system, we had an option to do it through the minimal invasive method. With its magnified vision, easier accessibility and dexterity, we could make a critical clinical decision during the surgery to go ahead with Ampullectomy. The success of this surgery will definitely motivate more surgeons to take this approach in future, to provide better clinical outcome to their patients.”

While expressing the excitement about the successful procedure, Dr. Jayant Mulchandani said, “The da Vinci RAS system has opened up incredible possibilities for surgical interventions in challenging areas like the ampulla of Vater. With enhanced visualization and robotic assistance, we can achieve precise movements and ensure optimal patient outcomes. This breakthrough will significantly benefit patients by reducing post-operative complications and speeding up recovery times.”

Dr. Mohammed Shies Sadat added that, “Equipped with sophisticated instruments and a high-definition 3D camera, the robotic platform provides a magnified view of the surgical field, enabling surgeons to perform intricate maneuvers with enhanced dexterity and accuracy.”

Commenting on her fast recovery Mrs. Sheetal Kumari (name changed), the patient, expressed her gratitude for the successful surgery, saying, “I am immensely thankful to Dr. Kudari and the team at Narayana Health Hospital for their exceptional care and expertise. Initially I was very nervous about the procedure, however, Dr. Kudari and his team did an excellent job in ensuring my safety and comfort. I’m happy that now I am healthy and better.”

The surgery was a success and the patient is recovering well.

With the highest number of Robotic Pancreatic surgeries in Karnataka, this team of doctors have profound experience in Robotic Pancreatic procedures and minimally invasive gastrointestinal surgeries, and is committed to further expand the application of Robot assisted surgery.