Lucknow: In a landmark achievement for urological surgery, doctors at SGPGIMS, Lucknow have successfully treated a very rare bladder tumor—urinary bladder paraganglioma—using a novel robotic transvesical approach, marking the first such reported case with this technique.
The patient, a 60-year-old male, presented with classical but alarming symptoms of bladder paraganglioma—recurrent episodes of palpitations, syncope, severe headache, and sudden spikes in blood pressure during urination. Such tumors are extremely uncommonand are known to release catecholamines when manipulated, making both surgery and anesthesia highly challenging.
The rare and challenging operation was carried out by Prof. Uday Pratap Singh, Professor of Urology and Renal Transplantation at SGPGIMS, along with his dedicated surgical teamincluding Dr Sanchit Rustagi, Dr Snigdh Garg, using a multi-port da Vinci Xi robotic system through a transvesical (through the bladder) approach, a technique that represents an ultra–minimally invasive advancement over conventional methods.
According to Prof Uday Pratap Singh, Traditionally, bladder tumors of this nature are managed via the transurethral, open or laparoscopic approach, requiring creation of pneumoperitoneum, extensive dissection around and behind the urinary bladder, and working dangerously close to vital structures. In this particular case, the tumor was in close proximity to the right ureter, placing it at significant risk of injury during conventional surgery.
However, the robotic transvesical approach completely avoided abdominal entry, eliminated the need for pneumoperitoneum, and bypassed dissection around the bladder and ureter, thereby significantly reducing surgical risk. This innovative technique allowed direct access to the tumor from within the bladder itself, ensuring precision, safety, and faster recovery.
Equally crucial was the role of the Anesthesia team, given the tumor’s tendency to cause sudden and dangerous blood pressure surges during handling. Prof. Sanjay Dhiraj, Prof. Amit Rastogi, Dr Prakash Chandra and Senior Resident Dr. Shivek expertly managed extreme intraoperative blood pressure fluctuations, ensuring patient safety throughout the procedure.
The operation was further supported by the highly skilled operation theatre staff, with Mr. ManojKumar Robotic OT in charge and Liji Joseph senior Nursing officerplaying a key role in ensuring smooth execution of this technically demanding surgery.
This pioneering procedure not only highlights the expanding role of robotics in urology but also establishes a new, safer surgical paradigm for rare functional bladder tumors. The success of this case demonstrates how innovation, teamwork, and advanced technology can converge to deliver world-class patient care.
This milestone places SGPGIMS prominently on the world map of cutting-edge medical innovation, offering renewed hope to patients with rare and complex conditions.
