Case One :
Mr.Pramod Colvalkar,78 years of age had an encapsulated collection of about 600ml of thick pus in his left chest in the space between the lungs and the ribs. Medically referred to as “Loculated Empyema Thoracis”, the ideal treatment for the same was a “Decortication of the Lung”. This meant removal of the bag of pus under General Anesthesia. In the chest this involves what is known as “One-Lung Anesthesia” – collapsing one lung for the surgeon to operate while ensuring that the other expands and ventilates normally to purify the blood. Also a bad chronic asthmatic, Mr.Pramod was not a candidate for General Anesthesia, let alone “One-Lung General Anesthesia”. This meant no scope of a Thoracoscopic Decortication .
The only option was to perform the surgery under “Thoracic Epidural Analgesia” i.e. with the patient awake but under a regional anesthetic into his back. Anesthesiologist Dr.Bernadette Crasto Dhabolkar was able and brave to let Dr.Irineu proceed with the procedure evacuating the pus from the chest of a wide awake Mr.Colvalkar.
The procedure was uneventful and Mr.Colvalkar was hale and hearty when he was discharged from the hospital after five days.
Case Two :
The family and treating physicians of Mr.Peter Fernandes found themselves in a similar situation. Peter, 88 years of age was found to have a hard to diagnose lung lesion despite all non-invasive as well as an endoscopic evaluation.
Dr.Irineu decided upon doing an “Open-Lung Biopsy under Thoracic Epidural Analgesia”. He found an able and brave anesthesiologist in Dr.Sandeep Pawar.
Mr.Peter underwent the procedure without any complications, had a positive diagnosis confirmed and was started on appropriate treatment.
Making Surgery Safe for The Patient and The patient Safe for Surgery is of paramount importance.. This may entail innovation and adaptation of surgical and anesthetic techniques to achieve the best possible patient results. After all a successful operation must mean a good patient result.