March 30, 2008

First hand experience of Pinhole/keyhole/laprascopic/thoracoscopic surgery

I will go thru the phases and stages of the events that ultimately is leading me to the hospital for the thoracoscopic surgery on 3rd of April. It wasn't a good experience and I am hoping that it comes to a satisfactory end with this surgery. I am hoping to recover fast and come back to post on my blog again soon around 15th of April.
It was September of 2006 and I went to Raffles hospital for medical checkup as part of pre employment check up. I went to thru a series of test as part of medical tests to confirm my fitness to be able to discharge my duties in good health that included chest X-Ray. I was called next day to collect the X-Ray report and to meet up with the doctor to do some other tests so that doctor could write up my fitness report. Next day upon arrival I was being asked to go for detailed chest X-ray as the radiologist is not able to make decision based on the previous X-ray and wants to re-affirm his suspicision based on this round of X-ray. I went thru another round of chest X-Ray. My appointment with the general physician who was supposed to write my fitness report was cancelled as general physician now needed a advice from thoracic expert and cardiologist. I was referred to Glen Eagles Hospital for expert advice from thoracic experts and cardiologist. In the absence of immediate dates I will have to see them 2 weeks later that's when I was able to get an appointment.
At this time I was in Bangalore[India] for a 2 week vacation. With this news My planned vacation had turned into series of marathons to multiple departments and doctors of Manipal Hospital in Bangalore. In the family there was a bit of palpable tension and every one wanted to get a 2nd advice from doctors in India too. I got an appointment with Thoracic expert. She adviced for CT scan. Next day CT scan was scheduled, this has to be done empty stomach. Day after tomorrow I will have consultation session with the specialist with the CT Scan report. She suspected the dreaded diseases TB[Tuberculosis] as the CT scan were showing 2-3 small scars not just one around that area and probabley in lungs. She adviced for montu[Mantoux test]. Me and family was having a night mare. I am so very normal and fine without any external symptoms. What all is there with in me hiding and waiting to explode. I cam back for next session with the Montu test. It was showing negative. She referred me to surgery section of Thoracic department for advice. There the thoracic surgeon adviced for endoscopy. Oh God!!!! another test next day morning - empty stomach. Next day morning I came back for the endoscopy. It was scheduled at 11 O'clock but for some emeregency that this surgeon had to attend to, I had to wait till 5 in evening. At about 5 PM I went for the endoscopy. It's not a nice experince at all with tubes going down your throat and all. After 2 hours of observation because of the mild anaesthesia during the endoscopy procedure I returned back home. Next appointment was next day noon with the reports of the endoscopy.
After all these tests thoracic sourgeon told that - there is some benign growth beside the food pipe adjacent to the heart. It's about a little less than a inch in length and width. It isn't harmful and you need to keep monitoring it's growth over time. May be you should get endoscopy done every 12 to 18 months where ever you are. In case there is any problem while swallowing food or whomitting or pain around that area get check up done immediately. You can also consider surgery to get it removed. Surgery will be advisable in case there is any further growth in the size. There are very little chances of it becoming malignant[cancerous] or it getting infected. How ever in case this happens it would be critical and immediate surgery would be required because of the proximity to heart and food pipe.
I was back to Singapore for work. I was at Glen Eagles Hospital for expert advice from thoracic experts and cardiologist regarding my fitness to take up the new appointment. Seeing these detailed test reports and finally the advice from the thoracic surgeon I was cleared fit to take up new appointment. How ever they adviced to go for endoscopy every 6-12 months instead of every 12-18 months.
I went for next Endoscopy in August 2007 to Glen Eagles Hospital and they referred me to NUH. No growth was reported and growth was still homogenous and smooth suggesting it's was not malignant. How ever I decided to go for the surgery as it was very frightening and uncomfortable to go for the endoscopy and wait for the results. It was like a bomb waiting to explode. There were some thoughts that at times body automatically absorbs these abnomral growth and it had not happened in my case so it was better to get it cleared thru surgical way. No more tension of this growth turning malignant or getting infected and affecting other body organs near by.

Note: Please also take a look at post titled Going for pin hole heart surgery. Above post is inspired by this post. Though there is no logical relation between both the posts.

Keywords: Some of these fairly technical. Each of them is an hyper link which will help you to learn and know more about it.
Laparoscopic surgery - Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, keyhole surgery, or pinhole surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5-1.5cm) as compared to larger incisions needed in traditional surgical procedures. Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy.

Chest X-ray - A chest X-ray, commonly abbreviated CXR, is a projection radiograph (X-ray), taken by a radiographer, of the thorax which is used to diagnose problems with that area.

CT Scan - Computed tomography (CT) is a medical imaging method employing tomography. Digital geometry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation. The word "tomography" is derived from the Greek tomos (slice) and graphein (to write).

TB[Tuberculosis] - Tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. Tuberculosis most commonly attacks the lungs (as pulmonary TB) but can also affect the central nervous system, the lymphatic system, the circulatory system, the genitourinary system, bones, joints and even the skin. Other mycobacteria such as Mycobacterium bovis, Mycobacterium africanum, Mycobacterium canetti, and Mycobacterium microti can also cause tuberculosis, but these species do not usually infect healthy adults.

Mantoux test - The Mantoux test (or Mantoux screening test, Tuberculin Sensitivity Test, Pirquet test, or PPD test for Purified Protein Derivative) is a diagnostic tool for tuberculosis. The Mantoux test is used in Australia, Canada, The Netherlands, Portugal, and the United States, it is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention (CDC). It was also used in the USSR, and now most ex-USSR countries. Multiple puncture tests such as the Tine test are not recommended. The Mantoux test is one of the two major tuberculin skin tests for tuberculosis used in the world. Until 2005, the Heaf test was used in the United Kingdom but the Mantoux test is now used.

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