KZN Health urologists make history through high-tech kidney stone removal operation

05 April 2018

KZN Health MEC Dr Sibongiseni Dhlomo has congratulated a team of urologists at a top Durban hospital for performing the first ever removal of kidney stones by using a needle, in a South African government health facility.

Known as mini percutaneous nephrolithotomy surgery and done by urologists at Inkosi Albert Luthuli Central Hospital, 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 hospitalised 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.

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.

Dr EH Abdel Goad, who led the operation of three patients last week, 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.

MEC Dhlomo and Dr Abel Goad
MEC Dhlomo and Dr Abel Goad
Dr SM Dhlomo

Dr A Goad

"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.

The patients, who are aged 58, 66, and 62, were operated on recently and are all doing well.

Dr Goad also paid tribute to the surgical team in Urology, the Nursing staff in Operating Theatre 4 and the anaesthetic department who were very supportive throughout the procedure.

I would like to thank my supportive team with Dr K Singh specialist urologist, and medical officers Dr D Naidoo, Dr N Munoo. Anaesthia is an important component of this type of surgery. The anaesthetic team lead by Dr S Verwey and Dr Y Seilbea, and nursing staff which was led by Sister RT Shabalala, all contributed to the success of these operations.

The support and encouragement of the management of IALCH is one of the factors that assisted the urology department to reach such achievement, he added.

MEC Dhlomo has expressed his delight at this achievement, and urged the urologists to continue working hard."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.

MEC Dhlomo also called upon South Africans to take heed of the call to avoid foods that increase the chances of having kidney stones.

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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This page last edited on 05 April, 2018

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