Robotic surgery marks Chicago breakthrough for pediatric patients

January 8, 2008

On Jan. 7, ten-year-old Jaime Bazan returned to school and sports activities--a monumental feat considering that only 11 days earlier, he became the first Chicago pediatric patient to undergo robot-assisted urologic surgery.

On Dec. 27, pediatric urologist Mohan S. Gundeti, MBBS, assistant professor of surgery at the University of Chicago Medical Center, performed a successful pyeloplasty to remove a blockage between Bazan's kidney and ureter. The boy returned home the day after surgery.

"He can jump, run, play football, and all the things he did before the surgery," said Gundeti, who joined the Comer Children's Hospital staff in November.

Doctors believe Bazan was born with a malformed ureter, which carries urine from the kidney to the bladder. Over the years, the boy occasionally complained of mild pain on his left side. In early November, the pain intensified. "He doubled over with pain," said his mother, Denise Gonzales.

Following an initial exam at St. Francis Hospital, physicians sent Bazan to Comer Children's Hospital, where they performed diagnostic tests and determined that fluid was accumulating in his left kidney. If left untreated the fluid could lead to infection and eventual kidney damage.

Gundeti performed the surgery with the Da Vinci robotic operating system, assisted by Greg Zagaja, associate professor of surgery. Through two half-inch and two one-third-inch-wide incisions, Gundeti used instruments with wrist-like articulation and a tiny camera that transmits a three-dimensional image.

"With minimally invasive surgery, patients experience less blood loss, fewer complications, less pain and less scarring," Gundeti said. "In a traditional pyeloplasty, the abdominal muscle is cut. In minimally invasive pyeloplasty, recuperation time is reduced because there is no muscle cutting. In addition, outcomes are as good as or better than traditional surgery."

Video and photographs are available.