At Royal Papworth, cardiothoracic surgeon, Mr Aman Coonar finds skill and experience pushed to the limit with 30-year-old patient, Dannee, who developed breathing problems and a persistent cough early in 2020.
It was initially thought to be COVID-19, but when the cough persisted a chest X-ray revealed a rare type of tumour in her bronchus – the airway that leads to the lung. By then the blockage had already caused serious infection, and Dannee was told that if the tumour was not removed it would threaten her life.
Aman and his team need to remove the tumour, part of the airway and the upper lobe of Dannee’s right lung. But then the team face the complex task of reattaching the lung to the remaining airway.
There are considerable risks. Aman must operate right up against the pulmonary artery – one of the biggest blood vessels in the body - where the slightest damage could cause a torrential bleed. If they cannot reattach the lung, then Dannee’s entire right lung might need to be removed.
At Addenbrooke’s, plastic surgeons Richard Price and Animesh Patel are also taking on a complex tumour and reconstruction. The duo’s patient – 68-year-old former fighter pilot Paul – has had recurrent basal cell carcinoma on his face.
Despite two small procedures to remove the cancer it has returned, and this time it has grown into the muscle and tissue around his temple and cheek and is dangerously close to his eye. If left untreated the cancer will continue to grow and could penetrate his eye socket and even his brain.
Richard and Animesh plan radical surgery to remove all the cancer in the hope that it doesn’t return. But this will require taking out a substantial amount of skin, muscle and bone, leaving a large hole in Paul’s face and a weakened eye socket. To fix what’s been taken away the surgeons not only have to use a metal plate to support the corner of Paul’s eye, but also harvest healthy skin from Paul’s thigh to fill the large gap.
Mr Coonar, who is a consultant surgeon and chair of the national thoracic surgery committee, said: “We are blessed with a kaleidoscope of great people at Royal Papworth who work as one team to provide excellent, compassionate care to our patients and their families.
“Dannee’s operation is far from straight forward and there are moments when we have to adapt to new challenges, so we are very grateful to Dannee and her wife Delia for allowing their story to be shared.”
Mr James Wheeler, divisional director for surgery and consultant colorectal surgeon at Addenbrooke’s, said: “This episode not only gives an insight into the amazing skills of our surgical teams, but also the incredible courage and determination of our patients.”
Image: Richard Price and Animesh Patel in the operating theatre