Two-year-old Stone Richman stood on a table and pointed to three tiny scars on his belly for his doctors and parents to see. They are his badges of honor for being the first patient to undergo a robot-assisted pyeloplasty using the da Vinci XI technology to fix his kidney blockage at Dell Children’s Medical Center (DCMC) a few months earlier.
The pediatric urologists who operated on Stone, Drs. Mary Katie Wang and Kelly Nast, nodded their approval. Then, they helped him down to continue his tour of the operating room where he once had been a patient. His mother scooped him up and set him in her lap at a nearby console letting him feel the controls his doctor used to direct the robot during his surgery.
Groundbreaking procedure
Stone revisited the high-tech surgical robot that was used in his ground-breaking surgery a few months earlier.
Stone’s operation was the first of its kind at a dedicated children’s hospital using this technology and allowed his left kidney to drain properly. He also has a congenital heart condition requiring cardiac anesthesia, highly specialized care that’s only available at DCMC in the Central Texas region.
Dr. Nast said the robot-assisted surgical platform offers several advantages to traditional open surgery for young children like Stone. The surgeon controls the robot’s four mechanical arms from a console with a magnified 3D view, directing small instruments and a camera inside the patient’s abdomen. This minimally invasive procedure typically involves smaller incisions, less blood loss and shorter recovery times compared to open surgery.
“Trying to keep a two-year-old calm for recovery after open surgery is a big ask,” she said. “We still have to restrict some activity for a couple of weeks after the operation, but usually they’re ready to go all out by then versus the longer recovery that an open incision requires.”
A mom and a DCMC associate
Dr. Kelly Nast, MD (right) visited with Stone and his mother, Karla Salerno
Stone’s mother, Karla Salerno, enthusiastically agreed. “The surgery only took an hour and he was trying to parkour off the walls once we left,” she said. “He was running around outside a couple of days later.”
Salerno is also a labor and delivery nurse at DCMC and appreciated having personal knowledge of the team that would care for her son.
“It feels like home,” she said. “This is not only my workplace but it’s where I’m comfortable taking my kid for care.”
Pediatric urologists, Drs. Nast, Wang and Vani Menon have over 30 years of combined robot-assisted surgical experience dedicated to providing advanced care for patients like Stone. With surgical case loads and volumes comparable to Houston and Dallas, these surgeons give Central Texas patients and their families access to advanced care in the comfort of their hometown.