Caulis Aristolochiae manshuriensis (CAM) is a kind of traditional Chinese medicine and can effectively increase the flow of urine, eliminate edema, remove heat from the lungs to relieve cough, encourage weight loss, and nourish a puerperant's body, so it has been widely used. However, in 1993, Belgian researchers found that CAM contained a kind of highly carcinogenic poison - aristolochic acid, the long-term consumption of which may lead to a renal disease that requires renal dialysis, kidney cancer, or urinary tract epithelial carcinoma. In 2003, certain regulations were published in Taiwan to inhibit the application of traditional Chinese medicine that contained aristolochic acid in order to avoid the misuse of relevant medicines, which could cause an irreparable tragedy.
Mr. Kao was 66 years old and came from Indonesia. Suffering from right kidney stones for years, he had taken a local treatment with Chinese herbal medicine that contained aristolochia manshuriensis for a long time. Then he felt increased pain in his lower back and had bloody urine, so he traveled to Malaysia and Singapore for further examination. The examination reports indicated that Mr. Kao had suffered from abnormal renal function and a ureteral tumor, giving Mr. Kao a terrible shock. When Mr. Kao was wondering what to do, a Taiwanese friend recommended the famous Linkou Branch of Chang Gung Memorial Hospital of Taiwan to him. Before long, Mr. Kao and his family went to Taiwan for treatment with the assistance of the hospital’s International Medical Center.
Dr. See-Tong Pang, the Director of the Division of Urologic Oncology, assumed responsibility for treating Mr. Kao. After evaluating Mr. Kao's medical records from other hospitals, Director Pang asked Mr. Kao whether he had ever taken traditional Chinese medicine containing aristolochic acid, such as manshuriensis. Director Pang's question surprised Mr. Kao and his family as they had not mentioned the medicine to other physicians because they had not known of its toxicity. Although the application of manshuriensis in medicine has been restricted in many countries, Director Pang knew that some people in Indonesia might secretly accept certain folk prescriptions; thus, he posed the question, which also indicated the cause of Mr. Kao's disease. Mr. Kao and his family admired Director Pang very much and felt fortunate that they had made the right choice to seek medical care at the Linkou Branch of Chang Gung Memorial Hospital in Taiwan.
Director Pang found that Mr. Kao's right ureter was distributed with tumors through a thorough examination and reached a consensus with Mr. Kao to adopt the Da Vinci Robotic System to excise the right kidney and ureter after considering both the advantages and disadvantages of traditional surgical excision and Da Vinci Robotic surgery. Compared to traditional surgery, the significant advantages of Da Vinci Robotic surgery include a small surgical incision, less pain, high safety, shorter hospitalization, and rapid return to normal life after the surgery. Mr. Kao's postoperative recovery was quite good. He was discharged on three days after the operation, his follow-up evaluation showed that he didn't suffer from any complications and had satisfactory wound healing, and he was able to take a plane to go back to Indonesia 11 days after the operation.
Mr. Kao deeply appreciated Director Pang and the international medical team’s help in ridding him of the old trouble that had haunted him for many years and wanted to share his experience with others and recommend Linkou Branch of Chang Gung Memorial Hospital of Taiwan to more patients.