Advanced surgical techniques get patient back on the playing field quickly
Aug 22, 2017, 11:27:36 AM CDT Sep 21, 2018, 12:07:11 PM CDT

Advanced Surgical Techniques Get Patient Back on the Playing Field Quickly

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When Jon, age 11, of Rochester, New York, was born, doctors discovered an obstruction in his right kidney that was preventing urine from flowing out of it and causing it to swell - a condition known as hydronephrosis.

At just 15 weeks old and weighing only 12 pounds, he underwent a surgery called an open pyeloplasty to drain and repair his kidney. For the next several years, Jon was watched closely by a team of urologists in his home state of New York to monitor any changes in his kidneys in case further surgical interventions were needed.

Just before his tenth birthday, Jon began having episodes of chronic pain and vomiting that, at first, his parents assumed were caused by a virus he may have caught at school. But after three or four occurrences, his mom Jackie mentioned it to his pediatrician who suggested an ultrasound, given Jon’s history of kidney issues. Though the ultrasound came back normal, Jon’s urologist requested he come back for another ultrasound during the next episode.

Shortly thereafter, Jon began experiencing intense abdominal pain again so his mom took him to the hospital where his care team was waiting. This time, doctors discovered that his left kidney was not draining properly, was severely distended and would require surgical repair. Though it wasn’t considered emergency surgery, doctors warned that delaying could result in additional painful episodes until the issue was fixed.

This time, Jon had a laparoscopic pyeloplasty on his left kidney in July 2016 and seemed to be on the road to recovery as school began in the fall. He started fifth grade, returned to his soccer team and celebrated the adoption of a new cousin with his family in New York City in November with no complications and little worries.

“I remember reassuring Jon that he only has two kidneys, and they’ve both been repaired so he really should have nothing to worry about,” says Jackie.

Unfortunately, however, after the New Year, Jon had another episode that left him doubled over in pain on the floor of the school nurse’s office. He went back to the ER for another ultrasound and testing which showed that the recent procedure in July had not been effective and that Jon would require surgery on his left kidney yet again.

The family began to weigh their options and look for a second opinion when Jon’s pediatrician suggested they consider a surgeon who had performed surgery on her own son about 10 years earlier.

The surgeon’s name was Craig Peters, M.D.

“We first ‘met’ Dr. Peters over email and shared Jon’s case with him to see if he could help,” Jackie says. “Later, we talked with him over the phone several times and were impressed by his knowledge and experience with kids in similar situations as Jon.”

Dr. Peters is the division director of pediatric urology at Children's Health℠ and a professor of urology at UT Southwestern Medical Center. He was an early developer of laparoscopic and robotic surgery techniques for urology patients and is viewed internationally as a subject matter expert with more than 20 years of experience in the field.

The family had an initial consult with Dr. Peters to discuss their options further and Jon came prepared with own list of 14 questions to ask him.

“Dr. Peters answered all his questions and treated Jon as an individual, not just a kid,” says Jackie. “He never pressured us into making a decision, but was honest with us that surgery was inevitable.”

Though the family talked to one other hospital closer to home, Jackie says it was the personal approach and caring, patient manner of Dr. Peters and his team that confirmed that Children’s Health was the very best option.

“We were certain we wanted to work only with a surgeon who had experience in repairing these complications as we were so worried about facing this all over again,” says Jackie. “This seemed like a far greater undertaking for our family, and especially for Jon, than the first two surgeries, and we were so happy to find Dr. Peters who has had so many opportunities to perform these corrections on other patients who needed a repeat operation.”

Jon and his family flew from Rochester to Dallas, and he had a robotic-assisted, laparoscopic pyeloplasty at Children’s Health on March 14, 2017.

The laparoscopic procedure requires just three small incisions, less than a centimeter each, through which small telescoping tools are inserted to repair the affected kidney. A small tube, or stent, is placed to assist with drainage and removed in a doctor’s office one to two weeks after surgery.

“This type of minimally invasive kidney surgery offers advantages beyond just smaller incisions and less pain after surgery,” says Dr. Peters. “The ability to see the anatomy very clearly and with a magnified view, to have precise control over instruments inside the body without a big incision, and the extra control and smoothness of the robotic surgical system is an improvement over conventional laparoscopic and even open surgery. We continue to explore further ways to take advantage of this technology in pediatric surgery.”

Jon was up and moving in recovery shortly after surgery. His recovery went smoothly, and Jon enjoyed playing video games in the playroom and visits from Van, a Golden Retriever and one of two dogs in the pet therapy program at Children’s Health.

“Van made me feel more at home,” Jon says.

Jackie says that as a parent, she appreciated the seamless communication between providers and her family compared to her prior experiences at other facilities.

“I’ve been at other hospitals where there are so many rotating teams coming in and out of the patient’s room and you have to keep telling your child’s story over and over,” she says. “But at Children’s, the urology team members were the only ones involved in his pre-op, surgery and post-op care, and they were all familiar with Jon’s needs.”

Jon and his mom flew home just four days after surgery, and he was back with his friends at school just three weeks later. By late April, he was back playing soccer with his team and enjoyed playing all summer long.

Dr. Peters and the urology team at Children’s Health are still closely following his progress, and he’s doing very well.

Jackie says there’s no question they made the right decision to come to Dallas for Jon’s care.

“I’d follow Dr. Peters anywhere,” she says. 

abdominal, chronic pain, kidney, patient story, USNWR, US News

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