Fortis Hospital conducts free-flap abdominal reconstructive surgery

New Delhi : Fortis Hospital Shalimar Bagh recently conducted highly elaborate and intricate surgeries on two International patients. Dr Richie Gupta, Head of Plastic and Reconstructive Surgery and Dr Pradeep Jain, Director, GI-ONCO and MAS along with their teams worked tirelessly to ensure that the patients were given the best treatment and care. Zekria Rammonzi, from Afghanistan and Kadhim Hasan Ali, from Iraqunderwent reconstructive surgeries of the abdomen which were executed in an intricate and carefully crafted manner.

Zekria Ramozi from Afganistan, 49 years of age was admitted to Fortis Shalimar Bagh on June 13th with a large tumor of Abdominal Wall, which was discharging Pus. In a previous Surgery done at Kabul, the surgeons were unable to excise it fully and after partial excision abandoned the procedure. To decrease the chance of recurrence, the tumor had to be excised with a wide margin (excessive amount of normal skin, muscles and abdominal wall to be removed around the tumor – 5 cm all around). As a result the final defect in abdominal wall would have become huge in future if not treated immediately and could not be covered simply by stretching or transposing local tissue. Two options were planned.

Option 1: to bring in tissue from entire left side of patients back as a free tissue transfer with microsurgical joining of vessels to restore blood flow. Option 2: to bring in tissue from thigh. At surgery, in view of huge defect, option 1 was chosen. The complex surgery took 10 hours. The patient was discharged after a duration of 10 day. Patient is recovering well and is all set to go home.

Khalid (name changed), a 36 year old solider who was grievously injured in a bomb blast, presented on June 26th at Fortis Shalimar Bagh with multiple injuries. He had undergone an earlier abdominal surgery with resection of the intestine with permanent colostomy on anterior abdominal wall. His right lower limb had also been amputated at pelvic level. On June 28th 2017 he underwent a 13 hour-long surgery for the correction of the huge anterior abdominal wall hernia that was covered with thin layer of skin. The defect size was 26.5 X 30 cm in size and could not be covered by utilizing mesh and surrounding muscles. After analyzing the dire situation, the doctors took the free muscle & skin flap from the right side of back and the vessels were joined using a microsurgical technique. The Patient remained on ventilator for 3 days and is recovering well.

According to Dr Pradeep Jain, Director, GI-ONCO and MAS, “In the first case the tumor had to be carefully excised along with a 5cm peripheral margin so that the disease was completely removed but it left the liver and intestines exposed. In the second case, the earlier skin cover was thin and fragile. The hernia was gradually increasing in size, causing severe pain and discomfort to the patient.”

Dr Richie Gupta, HOD, Plastic and Reconstructive Surgery, Fortis Hospital Shalimar Bagh said, “These were extremely challenging cases as these involved reconstruction of Abdominal Wall to protect internal organs which would otherwise have suffered severe damage. Largest flaps available in the body were used to cover these effects. Such large flaps require constant monitoring to detect early thrombosis and flap loss.”

Mr Mahipal Bhanot, Facility Director Fortis Hospital Shalimar Bagh, “We are glad that we could effectively provide treatment to the two international patients, this reflects our commitment to provide the best of healthcare services from patients across the world. Both our experts handling these cases excel in their fields. The reconstructive surgery space was a critical factor that made treatment in these cases possible and successful”

National Plastic and Reconstructive Surgery Day is observed on the 15th July. Plastic Surgery has become a boon as it’s no longer confined to cosmetic surgery. It also includes restoring the structure and function of various body areas through reconstructive surgery. Success of this type of surgery is assessed on the basis of functionality rather than look. It is clearly a boon to victims of burns, accidents, birth defects and post cancer resection defects. People suffering from these have no alternatives other than reconstructive plastic surgery in order to lead a normal life