Doctors at JIPMER successfully performed a high risk and critical operation on a 15-year-old boy to remove a vegetable cutter (aruvamanai) from the left chest cavity (Thoracic).
Prabhu of Mariammam Koil Street, Villupuram district in Tamil Nadu, was playing on a tree top when jumped on to the tiled roof of a house.
The roof gave way and Prabhu fell on his back on a vegetable cutter. The vegetable cutter penetrated below the diaphragm (between abdomen and thorax) on the left side from behind, in between the ninth and tenth ribs, and the tip of it was bulging anteriorly, two inches from the sterna (breast bone) border below the third rib without breaking the skin.
The vegetable cutter was moving with each heart beat, when the boy was brought to JIPMER on December 9.
A CT scan of the thorax was performed and an emergency surgery was done by a team of doctors under Dr Durga Prasad Rath, assistant professor, Department of Cardiothoracic and Vascular Surgery (CTVS), JIPMER.
The cutter had damaged Prabhu’s left lung surface, entered the outer layer of heart by making a rent, between the main artery of the lung and aorta (largest artery of body with damage to the outer part) and stuck to the anterior chest wall. The sharp surface of the cutter was rubbing against the blood vessels of the heart.
As the cutter had entered the abdomen between the spleen and left kidney, making two rents in the stomach and diaphragm each, the thorax was opened through the bed of the sixth rib.
The stomach found way into the thoracic cavity through the rent in the diaphragm.
Surgeons laid their hands in between the heart and cutter, to protect the blood vessels.
A second opening in the chest was on the ninth space near the handle of the cutter.
The ninth rib was cut and the skin opened anteriorly near the pointed end of the cutter to move it.
After a meticulous dissection, the cutter was removed from thorax. The surgery took six and half hours (from 12 pm to 6.30 pm). One unit of blood was given.
The rents in the diaphragm and stomach were set right after opening the abdomen anteriorly.
As Prabhu could not consume food, a feeding tube was placed in the small intestine.
Post-operative care was given and he was discharged on December 21 with the feeding tube, which was later removed.
A follow-up was done on February 28, and now the patient is on the path to recovery.