KZN urologists make history

MEC of Health Dr Sibongiseni Dhlomo and Dr EH Abdel Goad, who led the operation. photo supplied.

A TEAM of urologists from the Inkosi Albert Luthuli Central Hospital (IALCH) has performed the first ever removal of kidney stones by using a needle, in a South African government health facility.

Known as mini percutaneous nephrolithotomy surgery, this kind of surgery involves needle-puncture of the skin to get to the stones and remove them, rather than using the riskier “open” surgery where inner organs or tissue are exposed. Patients who undergo kidney stone removal through traditional open surgery are normally hospitalized for an additional seven to 10 days post-operation, compared to two to three days the case of the percutaneous approach, as performed by the urologists at IALCH.

Dr EH Abdel Goad, who led the operation of three patients said: “Our hospital carries the major burden of the management of urinary tract stones.Traditionally, percutaneous surgery (PCNL) was only done as an alternative to open surgery. However, access to the kidney was via a bigger 35f hole, due to the available instruments size. Again the risk of bleeding, losing the kidney and at least some loss of nephrons was the major obstacle for such surgeries.”

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Kidney stones form when a person’s urine contains more crystal-forming substances — such as calcium, oxalate and uric acid — than the fluid in the urine can dilute. Urine may also have fewer substances that prevent crystals from sticking together than necessary, which creates an environment for kidney stones to form. The patients who were operated are aged 58, 66, and 62 are all doing well.

“In the recent years, the instruments were modified to reach the smaller size of 12f (in comparison to 35F) which significantly minimised the risks associated with the traditional PCNL. I attended several meetings on improving the surgeries of MiniPCNL. The procedure is technically challenging. However, with the help of one of the local and international experts in traditional PCNL, Dr Haroon Patel, we were able to successfully operate on three patients. They were discharged after just two days,” said Dr Goad.

MEC Dhlomo has expressed his delight at this achievement, and urged the urologists to continue working hard. Dhlomo said: “I commend our team of urologists who have made this ground-breaking operation of removing kidney stones using this high technique of just inserting a needle in the skin and getting them out. It’s the first of its kind and we welcome it. We would want to say to our people, yes we are focusing on primary healthcare, but we are still very happy to see such procedures that use such a high level of technology. We thank the doctors for the good work that they’ve done. May they continue doing well and being an inspiration to others.”

Kidney stones can be prevented through staying hydrated by drinking more water; eating more calcium-rich food (such as raw milk, kale sardines and broccoli) and less sodium (Smoked, cured, salted or canned meat, fish or poultry including bacon, cold cuts, ham, frankfurters, sausage). Eating food with less animal protein (meat, fish, poultry, eggs and dairy) also decreases the chances of having kidney stones, and so does avoiding supplements with vitamin C.

 

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