Two elderly patients recently underwent video-assisted thoracoscopic surgery (VATS) for tumours in their chest region at a private hospital here.
A 67-year-old man with persistent chronic cough for three years was diagnosed with a mediastinal tumour (9x6.4 cm). Traditionally, such patients undergo sternotomy, where the breastbone is separated to remove the tumour. Doctors at the Institute of Cardiac and Aortic Disorders (ICAD) at SIMS Hospital, Vadapalani, decided to offer him an alternative – a subxiphoid uniport VATS procedure.
A 4-cm incision below the xiphoid process, located at the lower end of the breastbone, was made, and the entire tumour was removed without causing any ruptures. The doctors said the patient lost less than 30 ml of blood during the procedure. He was extubated the very next day and discharged two days post-surgery. He was completely free of pain or discomfort after the operation as well.
Another 63-year-old man, who had slurred speech and swallowing difficulties for over a fortnight, was referred to the ICAD by a neurologist after diagnosis revealed bulbar myasthenia gravis with a thymus tumour. In this patient too, thymothymectomy was done using the uniport subxiphoid method in the substernal region. The blood loss was only 15 ml. Post-procedure, the patient did not require analgesics and was discharged on the third day after surgery.
ICAD director V.V. Bashi told mediapersons here on Wednesday that VATS was a better choice as it not only reduced blood loss but also cut down on hospitalisation time. The breadwinner could return to work in no time. According to him, though minimally invasive procedures are expensive compared to conventional ones, which included making several incisions to insert cameras or the opening of the sternum, the benefits far outweighed the cost.
Rajkamal Vishnu, junior consultant, cardiothoracic surgeon, said the world over, VATS procedures were revolutionising management of pulmonary and cardiac diseases. “Technological advancements have made such procedures safe, even for elderly and frail patients,” he added.
Hospital vice-president Raju Sivasamy said minimally invasive procedure in thoracic surgeries bring many benefits to the patients. “The method exemplifies the medical excellence practised at our hospital,” he said.
Published - October 18, 2023 10:20 pm IST
