GH Docs Undertake Complex Hysterectomy on Paraplegic

Doctors at Raja Sir Ramasamy Mudaliyar (RSRM) Hospital in Royapuram successfully carried out a complicated hysterectomy on a 39-year-old paraplegic from Kumbakonam.

Kavitha (39), who was paraplegic and suffered from myelomeningocele, a birth defect in which the backbone and spinal canal do not close, was self-dependent until she suffered a prolapsed uterus a year back.

Private hospitals in Kumbakonam and Thanjavur refused to perform vaginal hysterectomy on her as it was difficult to administer anaesthesia and perform the surgery. She then approached doctors at Raja Sir Ramasamy Mudaliyar Hospital in Royapuram.

Doctors said the woman, who was less than three feet tall, was unable to recline, slept in prone position (on the belly), always sat up when awake, could only crawling around, and defecation and urination was involuntary. She had previously undergone a surgery to remove a cyst on her spinal cord.

A team of seven doctors operated on Kavitha on May 13. “In most cases, it is safe to administer anaesthesia in the spine and the surgery is done with the legs held up. But in her case, she was paraplegic from waist down. If she is not given anaesthesia, there could be a hypertensive crisis and there are chances of her dying on the table,” explained Dr AL Meenakshi Sundaram, anaesthetist, who was part of the team that performed the surgery.

A doctor explained that Kavitha was made to lie in a 45 degree head-up tilt position and anaesthesia was given through her windpipe with the anaesthetist standing on a stool. “We could not lift her lower limbs up like it is done in regular cases. She was also on manual ventilation throughout the surgery,” doctors said.

After the surgery, Kavitha was put in the intensive care unit. She is expected to be discharged in three days, said doctors.

source: http://www.newindianexpress.com / The New Indian Express / Home> Cities> Chennai / by Express News Service – Chennai / May 16th, 2014