Urology surgery: From the smallest to the tallest

By Maureen Gilmer, Riley Children’s Health senior writer, mgilmer1@iuhealth.org

From the smallest to the tallest: Meet two patients who couldn’t be more different, yet they had the same surgery for the same condition on the same day with the aid of the same surgical robot and the same human surgeon.

Five-month-old Jagger Horne nearly kicked 16-year-old Mark Shostak in his incision site last week when the two met for the first time, the day after their twin surgeries to repair a blockage near their ureters that was interfering with kidney function.

Jagger can’t stand up yet, but if he could, he would rise to just over 2 feet tall – 25.4 inches to be exact. Mark, on the other hand, towers over nearly everyone. He is 7 feet tall – with shoes on – he says with a smile.

As Avery Horne holds Jagger out to Mark, inviting him to hold the child, the teen grasps him under the arms awkwardly but with good humor, before handing him back to the boy’s mom.

Dr. Ben Whittam, urology surgeon, explained that both Mark and Jagger had surgery Aug. 19 with the aid of the da Vinci surgical robot, a gift from the Riley Children’s Foundation.

The advanced robotic system allows doctors to perform complex minimally invasive surgeries through tiny incisions, allowing for smaller scars, less blood loss and a faster recovery time.

Avery and Addison Horne acknowledge being nervous about the surgery because Jagger is so young, but they were reassured by their son’s care team.

“They walked us through the operation and eased our nerves,” Addison said.

He and his wife found out before Jagger was born that the boy’s left kidney was measuring larger than the right, indicating hydronephrosis, a swelling of the kidney due to a buildup of urine.

At Jagger’s two-month checkup, the swelling was worse, so the southern Indiana couple were put in touch with the Riley urology team, including nurse practitioner Taylor Wang. Once a diagnosis was confirmed, the surgery was scheduled.

In Mark’s case, he began suffering pain on his right side, and scans revealed his right kidney was enlarged due to the same condition as little Jagger. Their surgeries were scheduled back-to-back with Dr. Whittam and the operating room team.

“What’s so cool is we have two patients having the same operation, and despite the size discrepancy, we use the same size scopes, the same size instruments,” Dr. Whittam said. “Everything was the same, except maybe a slightly smaller suture for the baby. Everything else was identical, even the incision.”

The surgery is “incredibly effective,” the surgeon said. “Ninety-nine percent of the time, we fix the problem with a single operation.”

Mark, a junior at Carmel High School, is optimistic he will be back on the basketball court soon. He is ranked No. 14 in the state (Class of 2028) by the Indiana High School Athletic Association, according to his dad, Igor Shostak.

Dr. Whittam said with a little rest, Mark should be ready to get back on the court soon, indicating he could go “full speed” within a few weeks.

Because both patients recovered quickly, they were discharged from Riley within a day or two of surgery.

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org