Complicated surgery for toddler at GH

June 08, 2013 10:16 am | Updated 10:16 am IST - CHENNAI:

A minimally-invasive procedure to treat renal stones came to the aid of a one-and-a-half-year-old child at Rajiv Gandhi Government General Hospital (GH), recently.

Six days ago, Mohammed, whose family lives in Pattabiram underwent percutaneous nephrolithotomy (PCNL), a procedure to treat stones over 1.5 cm in size.

“The boy had a kidney stone measuring 2 cm. It was removed using in an endoscopic procedure. A small hole was made in his back and an instrument was directed to the kidney. The stone was broken and removed,” said R. Jeyaraman, professor and head, urology department, GH.

Listing the advantages of the procedure, he said that it leaves no big scar, there is no post-operative pain and the stay at the hospital is short.

There are several causes of kidney stones in children. Metabolic disorders can cause them. “Sometimes, congenital problems or familial disorders can also cause such stones,” said Dr. Jeyaraman. Also, children can develop kidney stones due to drinking too little water or drinking too many wrong types of fluids such as soft drinks or drinks with caffeine in them, Dr. Jeyaraman said.

An increase in obesity levels, sedentary lifestyles and diets high in salt are other contributing factors, doctors said. Symptoms of renal stones in children include pain, frequent crying, refusing food and fever. , in case of infection.

Another procedure to treat renal stones is extracorporeal shortwave lithotripsy (ECSWL), which is a non-invasive procedure. This is performed to treat stones less than 1.5 cm in size, Dr. Jeyaraman said. While the procedure is performed without anaesthesia for adults, it is performed under general anaesthesia for paediatric patients, he explained.

“In paediatric cases, we need to take extra care, especially with post-operative management. The procedure is technically different as the size of the kidney is small in children. It measures five to six cm in a one-and-a-half-year-old child. We have miniature instruments to carry out the procedure in children,” Dr. Jeyaraman said.

To date, a total of 23 children have undergone ESWL, while 12 children have been treated through PCNL at GH. GH dean V. Kanagasabai said PCNL costs around Rs. 60,000 at private hospitals.

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