Robot is better than laparoscopy, especially in a reconstructive surgery: Dr Mahesh Desai

Shahid Akhter, editor, ETHealthworld spoke to Dr Mahesh Desai, Medical Director, Muljibhai Patel Urological Hospital, Nadiad to get a glimpse of the changes that has impacted urology in the past 40 years. Edited excerpts:

Urology- Your interest, career & Journey so far

In 1978, the first thing I did was to establish a dialysis unit for patients with kidney failure, we were getting many patients of stones with kidney failure, where we can do surgery and remove the stone, but kidney failure requires a treatment like dialysis. In 2 years we were ready for kidney transplant, and on 6th April 1980 we did our first kidney transplant. Along with that there was a technological explosion in stone management from open surgery to minimal invasive surgery.

This new technology was definitely helping the patient to clear the stone but on the other side this technology was also costly and we had to decide which is the cost effective way to adapt a technique which will clear the stone. We were the first ones to do the ureteroscopy, we adapted this technology, we improved it from 1985 but in 1980 we did it by the lithotripsy then we were complete in the management of the stone. Ever since then we are involved in evolution and developing different types of treatment modalities. Now percutaneous nephrolithotomy (PCNL) is the first line of treatment, second is the ureteroscopy, now flexible ureteroscopy is also getting popular and lithotripsy has become small. The most important thing is that the stone needs to be completely cleared and when that is done the chances of recurrence is much less.

Kidney stone is a recurring disease, it can affect and can also destroy the kidney. This is a universal disease and it is equally present in the male and female, children and old age. We must adopt technology in such a way that it clears the stone completely and is also cost effective. So we have adopted PCNL as a way of clearing the stone because it is complete, it is the shortest and it is cost effective, along with stone surgery the transplant surgery also went on improving.

When laparoscopy came, we realised giving treatment without giving a large scar to the donor who is giving kidney to somebody else. Learning laparoscopy also helped us to take care of the kidney tumour. After 10 years came the robotic surgery aka robot assisted laparoscopic surgery. Robot is definitely better then the laparoscopy especially in a reconstructive surgery, in an cancer surgery, in kidney and the prostate cancer. I truly believe that technology helped us to treat the patients better.



Urology awareness and outreach

In our country some can afford treatment while many cannot and I believe that every person has the right to have world class treatment. Our hospital is a non profiting charitable institute and we have a lot of people who donate and we make sure that no patient is sent back. So we make sure that every patient is treated.