Fortis Surgeons Create Pharyngeal tube with part of small intestine

Dr Surender Dabas, Director, Head, Neck and Thoracic Surgical Oncology

BS RAWAT

NEW DELHI: Vimla Devi had squamous cell carcinoma in the laryngeal region. The goal of the reconstruction was to protect the carotid artery and to restore speech and swallowing in the patient impacted by the tumour.

By taking a part of her small intestine and creating a new pharyngeal tube with it, the surgeons at Fortis Hospital, Shalimar Bagh, Delhi, proved to be life savers for Vimla Devi from Rohtak.

The patient got a fresh lease of life after undergoing an over 12-hour operation on August 14, 2017, for removal of a malignant neck tumour.

Speaking to DTMT, the Hospital claimed the surgery was a "first of its kind" in North India.

Bimla Devi, 58,  who was earlier treated in Rohtak hospital was brought to the Fortis Hospital at Shalimar Bagh in a state of complete weakness and was being fed through an external apparatus as she had extreme trouble swallowing and breathing, doctors said.

An endoscopy and biopsy were performed proving the presence of a squamous cell carcinoma in the laryngeal region or hypopharynx. She had previously undergone treatment with radiation followed by eight cycles of palliative chemotherapy which had resulted in absolute dysphagia.

Dr Surender Dabas, Director (Head, Neck and Thoracic Surgical Oncology) told DTMT, "After reviewing her case, we decided to perform a total laryngopharyngectomy and reconstruction of pharyngeal tube with a free jejunal flap. Post the surgery the patient was kept on ventilator support for two days."

He said that the post-operative period was uneventful and smooth.

In this case, it was a post-cricoid carcinoma, her food pipe and windpipe that were affected, were removed," he said.

Dr Dabas stated, “ Pharyngoesophageal reconstruction requires great attention to detail, and there is no room for error. The ultimate goals of reconstruction are to provide protection of important structures such as the carotid artery, and restoration of funcctions such as speech and swallowing.”

"Vimla Devi is stable and kept under surveillance in the high-dependency unit. She would be discharged in next week," he said.

Mr Mahipal Bhanot, Director of the hospital, commended Dr Dabas and said: "It is with his positive and can-do attitude that even the most hopeless cases develop a silver lining and can be treated."