Fortis Hospitals surgeons perform combined surgey giving a new lease of life to an aged patient

Fortis Hospitals Bangalore has performed a unique combined surgery on an 83 year old patient who was suffering from severe heart disease for the past 4 years and also diagnosed of bladder cancer recently.
The patient S R Subhramaniam, ex-president and managing director of Larsen & Tourbo had a history of severe aortic stenosis problem. He was advised to Fortis and was prescribed to undergo Cystoscopy test which revealed cancer in the bladder.
The specialists recommended bladder resection surgery followed by creation of new bladder using a part of the patient’s small intestine through a process known as Neobladder.
“Though we advised Subramaniam for an immediate bladder reconstructive surgery, another major issue we faced was his heart condition which itself required a surgery to be done. On one hand, operating on the bladder cancer alone may have posed the patient to the risk of heart failure due to the narrowed aortic valve, on the other hand, operating on aortic valve would have postponed the cancer surgery on the bladder which could result in him bleeding from the urinary bladder in addition to spread of cancer cells. Therefore solving the two problems separately would not have been safe,” explained Dr Mohan Keshavamurthy, consultant urologist and Transplant Surgeon, Fortis Hospitals.
After detailed discussion, a decision was taken to undergo combined surgery where the heart and bladder cancer could be handled at the same time. The team represented by Dr Rehan Syed, Consultant Cardio-Thoracic Surgeon, Dr Mohan Keshavamurthy, Consultant Urologist and Transplant Surgeon, Dr Aashish Shah, Consultant GI Surgeon and Dr Murali Chakravarthy, Consultant Anaesthesiologist prepared a set of strategies to operate the patient in such a way that both the issues comprising the heart and the bladder could be dealt at one go. The specialists then moved ahead with the combined surgery starting with the cardiac procedure in the first half and the bladder reconstructive surgery later. After 6 hours of operation a unique Aortic valve replacement surgery with radical bladder resection and reconstruction with Ileal Neobladder was performed and the patient was cured of both the ailments.
According to Dr Syed, the procedure was challenging as the patient needed a minimal access valve replacement procedure where the the first few hours are critical and the bladder cancer was resected during that time. To my knowledge this is the first time such major surgeries are done in a single sitting.
Source:Pharmabiz