Bengaluru: Aster doctors perform miracle, free Odisha man from 17-year cancer curse

Bengaluru: A group of doctors at Aster CMI hospital have given a new lease of life to 31-year-old man from Odisha by successfully removing the plexiform neurofibroma on his face.

Manbodh Bagh from Odisha suffered from plexiform neurofibroma, a benign tumour of peripheral nerves, a condition that blighted his life since his childhood. As a result, he had developed a tumour on his face, and it grew as he aged. Weighing more than 8 kg, the growing mass drooping from the right side of his face caused Manbodh Bagh much public humiliation.

He visited multiple hospitals for resection of the tumour but the doctors refused to perform the surgery as his survival chances were bleak. A hospital in Odisha even attempted the surgery but had to abandon it due to uncontrolled bleeding.

To help him better his condition, Newslions Media Network Pvt Ltd crowdfunded his life-changing surgery through Milaap. Having raised enough funds for the surgery, he visited Aster CMI in Bengaluru for his treatment and the doctors accepted the challenge.

Over the period of six months, Manbodh had to undergo 16 different surgical procedures to get rid of the tumour. An expert group of medical professionals from various departments such as neurosurgery, plastic surgery, oncology, ENT, neuro-anaesthesia and ophthalmology, amongst the various departments, headed by Dr Ravi Gopal Varma, Lead Consultant - Neurosurgery & Chief of Neurosciences; Dr Madhusudan G, Lead and Senior Consultant - Plastic Surgery; Dr Sathish M S Vasishta, Consultant - Craniomaxillofacial Surgery; Dr Ravindra Battu, Sr. Consultant Ophthalmology; Dr Raghavendra Pai K, Lead Consultant – Neuroanaesthesia; Dr Girish G, Consultant - Surgical Oncology; Dr Santhosh N U, Consultant - Neurosurgery & Endovascular Neurosurgery and Dr Nirmala S, Consultant - Neurosurgery and a team of other doctors and surgeons.

The huge tumour was on the right side of the face, head and neck, and infiltrated the right orbit, completely engulfing the right eye. This is also what made the surgery quite risky and complex. "Dealing with such a highly complex case often requires different modalities of treatment and a multi-disciplinary approach.

So, the team carefully evaluated the case and provided a seamless approach to the treatment. During the surgery to minimize the bleeding, we planned pre-op tumour embolization. The DSA angiogram showed a significant tumour blush supplied by multiple branches of the facial artery, internal maxillary artery, superficial temporal artery and ophthalmic artery. Super selective catheterization of those multiple branches and tumour embolization was done using PVA Particles.

The Final angiogram showed a significant decrease in tumour blush which minimized the bleeding during surgery." said Dr Ravi Gopal Varma, Lead Consultant - Neurosurgery & Chief of Neurosciences, Aster CMI Hospital. The team was able to remove the tumour as well as restore his facial bones.

"The challenge was to restore it after the removal of the tumour. With his CT scans data, a 3D printed skull model of his face was made to assess the extent of the tumour and designed excision plan and reconstruction," said Dr Sathish M S Vasishta, Consultant - Craniomaxillofacial Surgery, Aster CMI Hospital.

"Once the tumour was removed, we took Manbodh up for reconstruction surgery after 48 hours. Most of his facial skin had to be removed as the tumour was densely adherent, resulting in a large composite skin and soft tissue defect over the entire right half of the face.

Reconstruction of such large defects which need microsurgical tissue transfer was challenging due to preoperative embolization. The entire reconstruction surgery was done in two stages by using three flaps skin and muscles of both his thighs as well as the right forearm.

In the first stage, right thigh skin and muscles were transferred by microsurgical means and in the second stage, a rare complex reconstruction method was used by connecting left thigh skin- muscle flap to his right forearm skin and transfer the combination of two flaps to the face by attaching hand to the forehead for three weeks." said Dr Madhusudan G, Lead and Senior Consultant - Plastic Surgery, Aster CMI Hospital.

During the surgery, the patient also suffered from heavy blood loss. "Nearly 40 litres of fluids, blood and blood components.

We had reserved 12 units of blood for this surgery, which is huge by regular standards and were able to get additional 8 units of blood in a short period," said Dr Raghavendra Pai K, Lead Consultant - Neuroanaesthesia, Aster CMI Hospital.