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Neurosurgery using Brain lab |
Congratulations to the team of MIND (Medica Institute of Neurological Diseases) for doing a pioneering case of Neurosurgery, performed 1st time in eastern India. The team used the Neuro Navigation System (Brain lab) to operate on a brain tumour of a 50-yr-old lady, successfully removing the tumour with help of navigation, MRI Tractography (DTI) and Pentero Microscope. The tumour was located in the speech centre and speech was affected pre-operatively. After removing the tumour speech has recovered and the patient is doing well. |
A Landmark Cardiac Surgery |
Mrs. Tripti Adhikari, a 72-year-old lady from Agartala, was diagnosed with Dilated Cardiomyopathy and complete heart block when she came to Medica Institute of Cardiac Sciences with chest pain and breathlessness. Dilated cardiomyopathy is a condition where the heart pumping goes down and patient develops recurrent heart failure. Gradually the dilated heart develops fibrosis, which leads to conduction abnormality. This conduction delay further decreases the cardiac output as the contraction becomes non-synchronized. Biventricular pacemaker is implanted in these patients to synchronise the contraction of the heart, which is why the procedure is also called cardiac resynchronization therapy. |
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The patient underwent biventricular pacemaker surgery at Medica Superspecialty Hospital on 14th August. For the first time in India, in a landmark surgery, three leads were introduced successfully through the cephalic vein. The conventional way of doing the surgery is by introducing three leads through subclavian vein puncture. This procedure is risky as it can cause pneumothorx, haemothorax and lead fracture if the leads get trapped between ribs and clavicle. However, introducing the leads through cephalic vein negates all such complications.
The procedure, though safer, had not yet been tried in our country. Introducing a single lead is often a routine procedure, but insertion of three leads through the cephalic vein is an exception. Even internationally, the procedure has been adapted by only some centres in America and Europe.
The surgery was performed by Dr. J Naik, Dr. Dilip Kumar and Dr. S. Basu. All three leads were introduced in the same cephalic vein at different locations. The patient started feeling better within hours of the procedure. With passing of time benefits of the surgery will become more visible due to remodeling of the heart as a consequence of the synchronized heart beats.
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Shoulder hemiarthroplasty on a 151kg patient
- an unusual challenge to the surgical & anaesthetic team
In an unanticipated challenge thrown to the medica orthopaedic & anaesthetic team, an operation had to be carried out for shoulder hemiarthroplasty on a 60 year old gentleman (name withheld on request) of Kolkata, who weighed 151kgs, suffered from severe sleep apnoea, obesity hypo ventilation syndrome (i.e. unable to lie flat), ischemic heart disease, bifasicular heart block, besides being a heavy smoker, hypertensive and having ill-controlled diabetic symptoms.
Although the operation was carried out successfully by Dr Vikas Kapoor and team, it had posed difficult anaesthetic challenges for the entire team in terms of arterial, central venous access, airway and ventilation issues. Nevertheless, with the experienced team of Dr Saikat Bandapadhyaya, Abhijit Sen & Dr Abhijit Paul, the clinical challenges were overcome soon. The patient is extubated and doing fine in the post operative surgical ICU, waiting to be transferred to the ward.
Congratulations to the entire orthopaedic team of Medica Superspecialty Hospital
for this wonderful achievement!
Successful Complex Mitral Valve Repair: A First in Kolkata
A rare and difficult operation was recently performed by Dr. Ratan Kumar Das (Senior Consultant Cardiac Thoracic Surgeon) and his team. The operation, called Resection Sliding Plasty, is a type of Mitral valve repair and requires a high degree of skill and precision to perform. Mr. Sudhakar Singh, a 23-year-old man, was admitted under Clinical Director Cardiology, Medica Institute Of Cardiac science.
The patient presented with congestive heart failure with inability to lie down. He had a past history of fever, which he had two years ago, suggestive of infective endocarditis (infection of heart). Echocardiogram revealed severe leak (regurgitation) in the mitral valve with poor LV function. First he was stabilized with injections and oxygen supplementation and then referred to the cardiothoracic surgery department.
Dr. Ratan Kumar Das took on this case as a challenge. In India valve replacement is preferred over repair because of the simplicity of the procedure. However, valve replacement at such a young age, wherein the patient would have deterioration in the LV function and also require lifelong anticoagulation, would have been a gross injustice done to the patient.
Dr. Das has been trained in Sydney where valve repair is a common thing with a high degree of success. Preserving the native valve was Dr. Das’ top most agenda when he started operating on the patient. In Resection Sliding Plasty, the diseased part of the valve leaflet is removed and the healthy parts are mobilized and attached to each other. The valve apparatus is finally strengthened by placing a semicircular ring around the annulus. The operation was performed successfully by Dr. Das, being the first such instance in Kolkata. The patient was discharged 10 days after surgery, with no further symptoms of heart failure.
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