As surgeons, we love what we do; and it is hard to imagine doing anything else. We love being at the center of drama, action, and excitement. We are constantly on the lookout for newer challenges and the adrenaline rush high they bring.
Last month, a young woman of 34 years, visited our outpatient department for a consultation; to get relief from the unrelenting jaundice she was suffering from, since 4 months. She had travelled a thousand miles from another city to seek advice on the right treatment for a tumour in her pancreas. The classical treatment for a pancreatic tumour is the Whipple’s surgery; which is undisputedly the most arduous and challenging gastrointestinal surgery.
And in keeping with the thirst for new challenges that allow him to always surpass himself; Dr. Lakdawala, a leading name in minimal access surgery Mumbai; decided to perform this surgery laparoscopically. The moment Dr. Lakdawala took this call; our entire unit started buzzing with concern. A Whipple’s surgery had never been done laparoscopically in this part of the country before. Though we had seen and done most of what there was to weight loss surgery in India; this was a first, and got us apprehensive and excited in equal measure. All of us were suddenly propelled into action with each surgeon in the unit preparing for the ‘D-day.’ We revisited our anatomy books to brush our memory of intricate blood vessels coming in and out of pancreas. The internet history on our laptops and iPads only revealed words like pancreas, Whipple’s, pancreatectomy, and so on. Considering the high rate of complications after this surgery, we had to be one hundred percent certain of our approach. Performing a Whipple’s surgery was a challenge in itself, but I guess the bigger challenge was to be able to perform the entire surgery laparoscopically.
On the night before the surgery, I think I was as nervous as the patient must have been. Though my boss was going to perform the procedure, I had to match up to him while assisting him. My colleague Amit had a lot of experience with the open Whipple’s surgery procedure. But even he postponed his annual leave, so that he didn’t miss his first laparoscopic Whipple’s.
On the day of surgery, we called in Dr. Rajiv Joshi, a long time friend of Dr. Lakdawala, as a standby surgeon. Dr. Joshi has extensive experience with open Whipple’s surgery which involves a very long incision on the abdomen. He came in about an hour later, expecting us to have given up on the laparoscopic approach by then. And then he started watching us, uncertain and skeptical at first, but encouraging and seemingly convinced later. His incredible transition from skepticism to conviction happened within three hours of the surgery and by the end of the fourth hour he was animatedly encouraging us to go the whole way laparoscopically!
Whipple’s surgery demands utmost precision from each member of the surgical team and even a tiny little mistake can have disastrous consequences. All GI surgeons fantasize about being a part of a Whipple’s at some point in their career. So for me, not only was this Whipple’s surgery experience a dream come true, but it was also a lot more fantastic because this was a laparoscopic Whipple! We completed the surgery successfully in less than six hours. It was an exhilarating experience and Dr. Rajiv Joshi was the first person to hug our boss! There was a lot of cheering, hugging, and commotion in the operating room. On that day, the success of the procedure made us feel that we had finally ‘done it all.’
Our patient went home within a week. She was lucky to not have any postoperative complications. She will remain one of our most precious patients not only because we were the first ones to perform a complicated surgery like Whipple’s laparoscopically on her, but because we could help a young patient of 34 years to get rid of a life threatening cancer; and take a second chance at living this beautiful life!
Written by Dr. Aparna Govil Bhasker
Consultant Surgeon – CODS