Patient Details
Age: 38
Gender: Female
Medical History: No significant past medical history
Case Presentation
A 38-year-old woman presented with acute breathlessness. Upon evaluation, she was diagnosed with a growth in the left main bronchus, the airway leading to the left lung. This growth caused a complete collapse and loss of function in the left lung. Initially referred for the removal of the entire left lung, Dr. George Karimundackal, a prominent thoracic surgeon in Mumbai, determined that a less invasive approach could be taken to save the lung.
Diagnosis
The patient was diagnosed with a growth obstructing the left main bronchus, resulting in the collapse of the left lung and acute respiratory distress.
Treatment
Dr. George Karimundackal and his team decided on a two-stage treatment plan to address the bronchial growth while conserving the lung:
- Initial Endoscopic Debulking: Partial removal of the bronchial growth to allow air entry into the left lung.
- Robotic-Assisted Surgery: Complex resection of the left main bronchus using robotic assistance to remove the remaining growth and restore airway continuity.
Symptoms
- Acute breathlessness
- Collapsed left lung
- Severe respiratory distress
Tests Performed
- Bronchoscopy: To visually inspect and partially remove the growth in the left main bronchus.
- Imaging Scan: To visualize the extent of lung collapse and monitor the effect of the initial endoscopic debulking.
- Follow-up Bronchoscopy and Scan: To monitor lung re-expansion and residual growth.
Detailed Description of Robotic Thymectomy
The patient first underwent a partial endoscopic removal of the bronchial growth. This procedure successfully reopened the left bronchus, allowing air to enter the left lung. As a result, the patient’s breathing improved significantly.
Following this, she was discharged to allow the lung infection to settle and promote natural lung re-expansion. After almost six weeks, she returned for a follow-up bronchoscopy and scan. The tests showed the left lung had fully re-expanded, but a small portion of the growth remained in the bronchus.
Dr. Karimundackal then scheduled a robotic-assisted surgery to remove the residual growth. This intricate procedure involved resecting the affected portion of the left main bronchus and re-suturing it to maintain the integrity of the airway. The robotic assistance allowed for precise surgical manipulation, reducing the risk of complications and preserving lung function.
Post-Operative Assessment
The patient’s postoperative recovery was smooth, preserving the entire left lung. She was discharged in stable condition and has since returned to normal activities, experiencing no respiratory issues. Follow-up assessments confirm that the lung is fully functional and free of growth. This highlights the effectiveness of the combined endoscopic and robotic-assisted surgical approach.
By opting for a conservative, multimodal treatment strategy, Dr. George Karimundackal effectively preserved the patient’s lung, significantly improving her quality of life and enabling her to resume normal activities without the burden of a major lung resection.