Addenbrooke’s and Royal Papworth hospitals in Cambridge are renowned for the expertise of their surgical staff. At both centres, surgeons undertake some of the most complex operations in the world, where technical skill is paramount as the margins for error are slim. In the third episode of this critically acclaimed series, the surgeons not only have to remove life-threatening disease but put their patients back together again to ensure their survival.
At Royal Papworth Hospital, cardiothoracic surgeon Aman Coonar takes on a challenging case which tests his skill and expertise to the limit. His patient, 30-year-old Dannee, started having trouble breathing and developed a persistent cough early in 2020. It was assumed to be Covid-19, but when her health deteriorated, she and her partner Delia persisted, and Dannee was finally given a chest x-ray. It revealed she had a rare type of tumour in her bronchus – the airway that leads to the lung. By then the blockage had already caused serious infection, and she was told that if the tumour was not removed, it would threaten her life.
Dannee’s condition brings her to Royal Papworth, where Aman takes on her case. To rid Dannee of the tumour and give her the best chance of a normal life, Aman needs to do what’s called a sleeve resection, taking out the tumour, part of the airway and the right upper lobe of Dannee’s lung. But then he faces the complex task of reattaching the lung to the remaining airway.
There are considerable risks. Aman must operate right up against the pulmonary artery – one of the biggest blood vessels in the body – where the slightest damage could cause a torrential bleed. But even when he does manage to remove the tumour, if Aman cannot reconnect the airway and lung, he will have to perform a pneumonectomy – the removal of the entire lung.
At Addenbrooke’s hospital, plastic surgeons Richard Price and Animesh Patel are also taking on a complex tumour and reconstruction that requires both their expertise. The duo’s patient – 68-year-old former fighter pilot Paul – has had recurrent basal cell carcinoma on his face. Despite numerous small procedures to remove the cancer, it has returned, and this time it has grown into the muscle and tissue around his temple and cheek and is dangerously close to his eye. If left untreated, the cancer will continue to grow and could penetrate his eye socket, and even his brain.
Richard and Animesh plan to do radical surgery to remove all the cancer in the hope that it does not return. But this will require taking out a substantial amount of skin, muscle and bone, leaving a large hole in Paul’s face and a weakened eye socket. To fix what has been taken away the surgeons not only have to use a metal plate to support the corner of Paul’s eye where bone has been removed, but also harvest a flap of healthy skin from Paul’s thigh to fill the large gap on the upper part of Paul’s face where the tumour has been taken away. But when the complex anatomy of Paul’s thigh leaves Animesh struggling to harvest the flap, the entire reconstruction is under threat.