The surgery was performed by a multidisciplinary team of surgeons at Mediclinic Airport Road Hospital during a nine-hour surgery
22 June 2022| Last updated on 24 June 2022
A 44 year old male patient presented at Mediclinic Airport Road Hospital with a rare and fast growing tumour found in the thoracic inlet area, involving the neck as well.
Unfortunately, the growth of the tumour could not have been prevented with medical treatment, therefore the tumour board members concluded that surgery remained the only option to relieve the patient from his debilitating symptoms and help him resume normal activity.
Although this critical surgery posed potential risks and complications given the tumour’s sensitive location, a multidisciplinary team comprising a consultant surgeon, orthopaedic upper limb surgeon, vascular surgeon, neurosurgeon and general surgeons with surgical oncology expertise, thoroughly planned the surgical approach with the help of the Radiology Department to avoid potential intra-operative and post-operative complications.
Possible side effects included incomplete resection of the tumour, injury to the right arm nerve roots, injury to major arm arteries and brain stroke.
The patient underwent a nine-hour surgery and the transition between teams went smoothly in coordination with the anaesthesia team.
The surgical strategy included multiple phases. Dr. Abdelmagid Eltayeb, Consultant Orthopaedic Surgeon, provided access to the area with utmost accuracy with preplanned personalised instruments tailored for the patient to ensure the most precise reconstruction of the collar bone ensuring a good surgical field without compromising the arm range of motion.
Subsequently, Dr. Abdul Rahman Maher, Consultant Vascular and Endovascular Surgeon, dissected and controlled the major vessels of the neck and arm ensuring medial and lateral control of this very delicate and central area, after which Dr. Anas Tawakol, Consultant Neurosurgeon, dissected and applied protectors to the nerve roots.
This was a very important step which protected the major nerves of the arm to preserve and ensure full motion of his arms since he is a person who relies on his arms to earn his living.
Left: Dr. Abdelmagid Eltayeb
Middle: Dr. Abdul Rahman Maher
Right: Dr. Anas Tawakol
The surgical planning was led by Dr. Haytham El Salhat, Consultant General Surgeon and Surgical Oncologist, who had multiple meetings with the team, where they ensured all the required instrumentation was in place.
Scrub nurses and the anesthesia team were present in this case, to ensure a flawless operation with the best outcome for the patient.
After hours of surgical exposure, the mass of 900gm spanning from the middle of the lower neck down to the lower level shoulder blade in the posterior chest, extending to the spine medially, was removed by the General Surgery team of Dr. Haytham N. Elsalhat and Dr. Ibrahim Turki Tamur. Once that was done, the process of reconstruction took place. The surgery was uneventful.
Left: Dr. Haytham N. El Salhat
Right: Dr. Ibrahim Turki Tamur
The patient required another operation to repair the right thoracic duct and was eventually discharged home after two weeks.
Although the invasive nine hour long surgery posed high risks, the patient did not suffer any nerve damage.