Dec 08, 2021 News
Kaieteur News – Doctors attached to the Georgetown Public Hospital Corporation (GPHC) recently conducted a ground breaking ruptured Abdominal Aortic Aneurysm (AAA) surgery which was successfully done along with two other similarly critical procedures saving the lives of three patients at the facility.
The team of doctors spoke to the media about the three advanced procedures during a press conference held at GPHC last week. In addition to the AAA surgery, doctors also performed advanced laparoscopic adrenalectomy as well as gallbladder cancer cholecystectomy, and hepatectomy.
Dr. Carlos Martin; General and Vascular Surgeon, Dr. Kishore Persaud, Head of the Transplant and Vascular Department at GPHC led the team that conducted the ruptured AAA and emergency graft repair surgery explained that the operation was performed on a 36-year-old male patient from Mahaica.
During the press conference, Dr. Persaud explained that the patient was admitted to the hospital in a state which required surgery almost immediately. He noted that while AAA surgeries would’ve been performed in Guyana in the past, this would have been the first time that one would have ruptured.
The doctors noted too that by the time the patient was ready for surgery he went into hypovolemic shock and the aneurysm is a ballooning within the artery wall. “So it was basically an emergency procedure,” Dr. Persaud said adding that with that condition every second counts. The doctors noted that the success of the operation is noteworthy since that the survival rate for such procedures at quite low even at advanced medical facilities in the developed world
“About 65 percent of patients with this condition die before getting to the hospital and the fatally rate for these procedures are quite significant so the success of the operation is testament to fact that GPHC is moving in the right direction,” Dr. Martin added.
The doctor explained that the patient who benefitted from the operation has been placed in recovery and is doing pretty well, post surgery.
“The patient is in a stable condition, recovering and doing well,” he said. Meanwhile, Dr. Persaud said while aortic aneurysms were done before at GPHC, this is the first case that surgery was performed on a ruptured aortic aneurysm.
He explained that the surgery was possible, particularly because of the availability of the synthetic grafting materials.
Persaud noted “It’s the graft that allowed us to perform such a lifesaving surgery. We have the resources, in terms of the technical capabilities and human resources, but we are lacking the grafts to do other such surgeries. If we do not have more vascular grafts available, we would not be able perform more such surgeries. We are working with the administration to hopefully change that soon.”
Dr. Delon Ramnarine, Registrar General Surgery and Dr. Hemraj Ramcharran, General Consultant and Advanced Laparoscopic Surgeon, performed first-advanced laparoscopic adrenalectomy on a 54 -year- old patient from Berbice.
The woman was diagnosed with a pheochromocytoma after suffering with uncontrolled high blood pressure. As such, the procedure she underwent involved the removal of the adrenal gland. Dr. Ramcharran noted that the procedure not usually done in Guyana so to have it done at GPHC is quite a momentous occasion.
Dr. Ramcharran who trained in Canada to conduct the advanced operation explained that as opposed to open surgery where a surgeon makes incisions 6–12 inches long in order to access organs, laparoscopic surgery is a minimally invasive surgery, whereby notably smaller cuts are made, and the doctor conducts the surgery via inserted cameras. The procedure included a number of surgeons, anaesthetists and an endocrinologist.
He noted that critical to this procedure was stabilizing the patient’s blood pressure to a level necessary for surgery. “We did four small holes in the abdomen; we put in some cameras and equipment, and we did the entire surgery through the four small holes,” Dr. Ramcharran added. He noted that the procedure allows for a faster recovery rate.
“In our case, our patient was walking the next morning with minimal pain, eating and tolerating a regular diet.” With regard to future operations, Ramcharran said that steps are being taken to have the procedure done more regularly at the hospital.
“CEO, Robbie Rambarran and Dr. Navin Rambaran, Head of Department of Surgery have been quite helpful with having the equipment provided by the hospital as we work towards building capacity to do more surgeries” the doctor added.
Meanwhile, “gallbladder cancer cholecystectomy, and hepatectomy” surgery was performed on a 50-year-old female with a history of ovarian cancer.
The surgery was successfully led by Dr. Drohinath Singh, Chief Resident, General Surgery and Dr. Duan Yun Fei Hepatobiliary Surgeon, of the Chinese Medical team which recently arrived in Guyana. The surgery involved the removal of the gall bladder, and the removal of part of the liver. Dr. Yunfei played a critical role in the hepatectomy an expertise that is not available here in Guyana. Dr. Singh explained that “That surgery was a bit challenging, because of the blood loss that can occur.”
“We are dealing with the liver which is a vascular organ which meant a lot of bleeding can occur but Dr. Yunfei was very skillful, and able to go through the surgery with minimal blood loss,” he added.
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