CHENNAI: Paediatric surgeons at the Government Stanley Hospital have removed a ping pong ball sized tumour from the chest of a four-year-old through a pint-sized hole.
Using a minimally invasive technique called VATS (Video Assisted Thoracoscopic Surgery), the surgeons avoided splitting her rib cage down the centre and leaving a large 10-cm scar across her chest.
The child, P Varshini, who had endured breathlessness since she was about two months old, was admitted at the Government Hospital of Thoracic Medicine in Tambaram, after her parents suspected the ailment to be tuberculosis. Chest X-rays taken by doctors there showed a growth in her posterior mediastinum, which is part of the cavity that separates the lungs from the chest. Suspecting it to be a tumour, she was referred to the Government Stanley Hospital. Here, a CT scan helped reveal the tumour that was compressing her areola tissue and the lymph nodes close to the airway, thus causing breathlessness.
However, removing the tumour by a conventional method would have scarred Varshini for life. “A 10-cm incision on the chest would have had to be made,” said dean P Karkuzhali.
Speaking to CE, Director of Paediatrics, Dr Chitra Ayyappan said that VATS was a boon. “In the conventional method, the rib cage will have to be cut apart using a rib retractor. This always carries a risk of inflicting rib fracture. Besides, the post-op pain will be immense and the child would not have been able to bear it,” she said.
Explaining VATS, Dr R Senthil Nathan, the paediatric surgeon who conducted the operation said, “A 1-cm hole is cut and a video telescope with a camera attached to it is inserted. This will transmit the images as we make the incisions,” he said. “The fluid in the tumour was sucked out and then we cut out the cyst,” he added.
Varshini’s case was tricky, doctors said. Her tumour was asymptomatic. “Most tumours of this variety would show symptoms such as palpitation, high blood pressure. Her urine samples too didn’t reveal aberrations normally attributed to the tumour,” said Dr Chitra.
But for Varshini’s parents, Pazhani, a coolie, and Ramya, a housewife, conducting the surgery at Stanley helped. “In any other private hospital, this would have cost at least `4 lakh. At Stanley, it was done for free and the costs was covered under the TN Chief Minister’s Comprehensive Insurance Scheme,” dean Karkuzhali added.