Dr. Asim Rizvi

Robotic Milestone in Advanced Cancer Surgery: Combined Robotic LAR with Portal Vein Ligation

Our surgical oncology team recently achieved another important milestone in minimally invasive cancer surgery by successfully performing a Robotic Low Anterior Resection (LAR) combined with robotic ligation of the right portal vein in a 50-year-old female diagnosed with rectal cancer and synchronous liver metastasis.

The patient presented with rectal adenocarcinoma along with metastatic disease involving the right lobe of the liver. Managing such complex cases requires meticulous planning to achieve complete oncological clearance while preserving adequate liver function.

After multidisciplinary tumor board discussion, a staged surgical strategy was planned with curative intent. In the first stage, a robotic low anterior resection was performed following total mesorectal excision principles to remove the rectal primary tumor. During the same sitting, robotic ligation of the right branch of the portal vein was carried out. This step is designed to induce hypertrophy of the future liver remnant, allowing safe completion of a planned right hepatectomy after approximately four weeks.

The use of robotic technology enabled precise pelvic dissection, superior visualization, and delicate hilar vascular control, allowing two major oncologic objectives to be achieved through a minimally invasive approach. The patient tolerated the procedure well and is recovering satisfactorily while awaiting the second-stage liver surgery.

This combined robotic approach highlights the evolving role of advanced minimally invasive surgery in complex gastrointestinal and hepatobiliary oncology. By integrating colorectal and liver strategies in a single operation, patients benefit from reduced surgical trauma, faster recovery, and preservation of curative treatment pathways.

The case reflects our institution’s continued commitment to innovation, multidisciplinary collaboration, and delivery of world-class cancer care using cutting-edge robotic surgical techniques.

Treatment By:
Dr. Asim Rizvi

A patient diagnosed with a tumour in the head of the pancreas presented for specialised evaluation and management. Given the complexity of the condition, a detailed clinical assessment and surgical planning were undertaken by the expert team.

The patient was planned for a Robotic Pancreaticoduodenectomy (Whipple’s Procedure), a highly specialised surgery used to treat tumours in this region. The procedure was performed under the expertise of Dr. Syed Asim Rizvi, Principal Director – Surgical Oncology and Robotic Surgery, along with his team, using advanced robotic surgical technology.

The robotic approach provided enhanced precision and superior visualisation, enabling meticulous removal of the tumour while preserving surrounding structures. This minimally invasive technique also helped reduce intraoperative blood loss and supported a more controlled surgical environment.

The patient demonstrated a smooth postoperative recovery with reduced pain, early mobilisation, and overall improved comfort. He was discharged in stable condition.

This case highlights the role of advanced robotic surgery in managing complex pancreatic tumours, combining surgical expertise with precision technology to achieve optimal patient outcomes.

Treatment By:
Dr. Asim Rizvi

A 39-year-old patient from Nairobi presented with symptoms of obstructive jaundice and required urgent evaluation. A comprehensive diagnostic workup, including advanced imaging and endoscopic assessment, confirmed the diagnosis of pancreatic cancer.

The clinical team first focused on stabilising the patient and relieving the obstruction. A therapeutic endoscopic procedure with stenting was performed, leading to improvement in symptoms and liver function. Once optimised, the patient was carefully planned for definitive surgical management.

The surgery was performed under the expertise of Dr. Syed Asim Rizvi, Principal Director – Surgical Oncology and Robotic Surgery, using advanced robotic surgical technology. This approach enabled enhanced precision, minimal blood loss, and a minimally invasive pathway to treatment.

The patient showed a smooth postoperative recovery, with early initiation of oral intake, timely mobilisation, and reduced discomfort. He was discharged in stable condition within a week of the procedure.

This case highlights the importance of timely diagnosis, structured clinical management, and the role of advanced robotic surgery in improving outcomes for complex pancreatic cancer cases.

Treatment By:
Dr. Asim Rizvi

A patient with a long-standing history of lymphedema in her right arm since 2014 presented with persistent swelling and concerning changes in the affected limb. Clinical evaluation and further investigations, including PET scan and FNAC, confirmed the presence of a rare and aggressive malignancy involving the cutaneous and subcutaneous tissues of the forearm, diagnosed as lymphangiosarcoma.

Given the complexity of the condition and the risk to limb function, a carefully planned, patient-centric treatment approach was undertaken under the care of Dr. Manish Singhal, Vice Chairman – Medical Oncology, Yashoda Institute of Cancer Care.

The patient was treated with a combination of advanced chemotherapy and targeted therapy. The treatment was precisely tailored to control disease progression while prioritising limb preservation.

She responded well to therapy, with effective disease control achieved without the need for amputation. The limb was successfully preserved, maintaining both function and quality of life.

This case highlights the role of precision oncology and timely intervention in managing rare and challenging cancers, demonstrating how advanced treatment strategies can achieve optimal outcomes while preserving function and improving patient well-being.

Treatment By:
Dr. Manish Singhal

A 78-year-old male patient presented with difficulty in swallowing and a small growth at the base of the tongue. Initial evaluation, including biopsy and imaging, confirmed a malignancy involving the tongue along with an affected lymph node in the neck.

As part of routine staging, a whole-body scan revealed an additional lesion in the upper lobe of the lung with associated chest lymph nodes. Further evaluation confirmed this to be a second, unrelated primary cancer. This rare presentation of two simultaneous primary cancers required a carefully coordinated and highly specialised treatment approach.

After a detailed assessment by a multidisciplinary team, a comprehensive treatment plan was developed with curative intent. The patient was treated using advanced adaptive radiotherapy, a technique that allows real-time adjustments to radiation delivery based on daily imaging and anatomical changes, ensuring high precision and safety.

Both cancers were treated concurrently. The lung and chest lymph nodes received a planned course of radiation over six weeks, while the tongue and neck region were treated over seven weeks. Each session was guided by high-resolution imaging, enabling accurate targeting of the tumours while preserving surrounding healthy structures. The patient completed the treatment successfully with good tolerance. He showed a steady recovery and continues to remain stable on follow-up.

This case highlights the power of advanced radiation technology and multidisciplinary expertise in managing rare and complex cancer presentations.
 

Treatment By:
Dr. Gagan Saini

A 55-year-old woman diagnosed with advanced high-grade serous ovarian cancer presented after completing three cycles of neoadjuvant chemotherapy. She had responded well to treatment, with imaging showing significant disease resolution and tumour markers returning to normal levels. Following a comprehensive evaluation, she was planned for interval debulking surgery combined with Heated Intraperitoneal Chemotherapy (HIPEC).

After detailed counselling and preoperative optimisation, the patient underwent surgery under the care of the expert team. A meticulous cytoreductive procedure was performed to remove all visible disease, followed by the administration of HIPEC, a targeted chemotherapy delivered directly into the abdominal cavity using specialised equipment over a controlled duration. The entire procedure was carried out with precise monitoring and a highly coordinated approach.

Postoperatively, the patient was closely monitored with a structured care protocol, including optimal fluid management and regular assessment of clinical parameters to support recovery.

The patient demonstrated a smooth and steady recovery and was discharged in stable condition on the eighth postoperative day. She continues to do well on follow-up.

This case marks a significant milestone as one of the successful HIPEC procedures performed at Yashoda Medicity, highlighting the team’s expertise in delivering advanced oncological care with precision and safety.

Treatment By:
Dr. Satinder Kaur, Dr. Hemlata Garg, and Dr. Ipshita Sahoo

A 30-year-old woman presented with abdominal fullness and on/off pain for the last 3 months, without any menstrual concerns. Imaging revealed a large abdomino-pelvic mass with multiple nodular growths extending into the abdomen, suggestive of a rare condition where multiple fibroids are spread across the abdominal cavity and involve surrounding organs.

After detailed evaluation and counselling, a surgical plan was carefully designed with a strong focus on preserving her fertility. The patient underwent exploratory surgery under the care of the expert team.

During the procedure, multiple fibroids of varying sizes were identified arising from the uterus and extending into the pelvic and upper abdominal regions. A highly precise and carefully controlled surgical approach was adopted to safely remove the fibroids while preserving the uterus and both ovaries.

The surgery lasted approximately five hours, during which 15 fibroids weighing nearly 3 kg were successfully removed with minimal blood loss. The uterus and both ovaries were preserved, maintaining the patient’s reproductive potential.

The patient had a smooth recovery and was discharged in stable condition. This case highlights the team’s expertise in managing rare and complex conditions with a focus on precision, safety, and organ preservation, ensuring the best possible outcome for the patient.

Treatment By:
Dr. Satinder Kaur, Dr. Hemlata Garg, and Dr. Ipshita Sahoo