Hyderabad surgeons achieve national first with groundbreaking ureteral reconstruction

In a remarkable medical breakthrough, doctors at Preeti Urology and Kidney Hospital have performed India’s first bilateral ureteral reconstruction using laparoscopic surgery — a procedure so rare, only nine such cases have been documented worldwide.

The unprecedented 9.5-hour operation was carried out on a 52-year-old woman suffering from complete ureteral damage — a complication that arose from a hysterectomy she underwent three years ago. Left untreated, the condition could have led to irreversible kidney failure.

“The damage was extensive — both ureters had deteriorated along a 35 cm stretch, leaving only the renal pelvis intact,” said Dr. V Chandramohan, Managing Director and lead Consultant Urologist at the hospital. “Without surgical intervention, the patient was at risk of complete renal shutdown.”

A rare and challenging diagnosis

Upon evaluation, doctors found the patient had suffered severe post-surgical complications that had completely destroyed both ureters — the ducts responsible for transporting urine from the kidneys to the bladder. While temporary stents had been used earlier, her condition had continued to decline, marked by recurring infections and elevated creatinine levels, signaling kidney distress.

Pioneering minimally invasive surgery

In a bold move, Dr. Chandramohan’s team opted for a minimally invasive laparoscopic approach, making 13 small incisions — significantly more than the standard three — to navigate the complexity of the procedure.

“We harvested two 35 cm segments of the patient’s small intestine, carefully reshaped them, and connected each from the kidney to the bladder to act as replacement ureters,” Dr. Chandramohan explained. “Given that both ureters were completely non-functional, this was the only way to restore urinary flow and save kidney function.”

First in India, among a handful worldwide

According to Dr. Chandramohan, this is the first time in India that such a surgery has been executed entirely laparoscopically. “Similar procedures have only been reported in China — and even there, in fewer than ten documented cases,” he noted. “In India, bilateral ureteral reconstructions have previously been performed only through open surgery, making this minimally invasive success a national milestone.”

A new lease on life

The patient has since made a strong recovery. Her kidney function has stabilized, creatinine levels are back to normal, and she is able to walk unassisted.

“This success is not just a testament to surgical skill, but also to the power of advanced medical technology,” Dr. Chandramohan said during a press briefing at Taj Deccan Hotel. “It underscores the potential of laparoscopic techniques in tackling even the rarest and most complex urological cases.”

The team at Preeti Urology hopes this achievement will open doors to more minimally invasive solutions for patients facing severe urological complications across India.