Shija gives new lease of life to morbidly obese woman
Source: Chronicle News Service
Imphal, May 06 2022:
Shija Hospitals & Research Institute (SHRI) has reportedly helped improve the life of a morbidly obese woman courtesy of the hospital's multidisciplinary team, laparoscopy and ICU unit.
According to a SHRI release, a 45-year old woman visited the hospital's Gynaecology OPD with a right ovarian cyst on April 9, 2022.An uncomplicated ovarian cyst can be managed routinely using laparoscopic technique by most surgeons without undue complications.
But this patient was no routine case.
She weighed a whopping 120 kg and stood 5.4 feet tall, was a known hypertensive and had symptoms of acid reflux (acidity/gastritis).
A normal BMI falls in the range of 18.5-24.9 with the least risk of developing health problems.
The patient with a calculated BMI of 45.45 fell under Class 3 obesity with extremely high risk of developing health problems, the release elaborated.
It informed that the patient was initially scheduled for surgery in another hospital in the city, but unfortunately the procedure was abandoned due to a complication developed during the induction of anaesthesia.
Despite the fear looming over her, she was determined to get the procedure done, so she visited SHRI for the surgery.
Managing a morbidly obese patient in the OT is not a routine case in Manipur.
As such, a well-planned management technique was tailored by gynaecologist Dr Phijam Dhaneshwor and an anaesthesia team led by Dr Kennedy Taiyenjam and Dr Dinesh Thounaojam.
Preoperatively, she was evaluated by cardiologist Dr Sumidra Laishram to look for her baseline heart function and later put on low molecular weight heparin (blood thinner) to reduce the chances of clot formation and other complications which can occur in obese patients.
Despite all these preparations, the patient and her family were explained of the need of ICU admission postoperatively, the release continued.
Apart from the difficulties likely to be faced by the surgeon, the anaesthesiologist can also face significant difficulties in the operating room when dealing with such obese patients.
Almost routinely, in such difficult cases a team of anaesthesiologists work together to manage the case rather, than manage single-handedly.
The SHRI release explained further that although general anaesthesia is likened to a "sleep" for the public, it is no natural sleep with all the normal physiblogy getting altered with maximum impact on the respiratory system (lung).
Induction of anaesthesia and reversal are considered the most crucial steps, both of which were done skilfully in this case.
The surgical procedure required a certain position for better visualization of the organs, but the gynaecologist had to compromise oh it due to the anticipated problems expected in the obese patient with extremes of positioning.
Despite the surgical position limitations, the gynaecologist successfully removed the ovarian cyst (laparoscopic) on April 15.Patient was shifted to the ICU and removed from the ventilator after few hours.
Early mobilization and physiotherapy were initiated the very next day.
The patient's condition gradually improved with the treatment provided and was discharged from the hospital on April 17 .
Comment
