Hubli doctors perform rare surgery

By M. Madan Mohan

HUBLI, MAY 12. A team of doctors from Hubli has completed a difficult surgery involving the removal of an extra limb which was attached to the spinal chord at the back of a woman's neck.

The congenital problem had not affected the normal life of the woman, from Kushtagi in Koppal District. However, she had been feeling a weakness in the legs in the last one year and needed assistance to move. She suffered from a breathing problem and also found it difficult to move her neck.

The woman, who has four children, consulted a doctor at Gangavati, who referred her to Dr. Suresh Duggani, who runs

the Regional Neuro Science Centre in Hubli. ``The case was both complicated and challenging,'' Dr. Duggani, who removed the anomaly in a six-hour operation, told this correspondent. ``I had not seen such a case in my career either here or during my seven- year stint at NIMHANS in Bangalore. I had only read about in textbooks,'' he said.

The extra limb was attached to the cervical spine, and the compression on the cervical chord was causing weakness in all four limbs. An X-ray showed that the growth occurred at the junction of the spinal cord and the brain stem. The growth was quite extensive. Since it was a sensitive area where the major nerve vessels traversed, there were risks inherent in any surgery.

Dr. Duggani said that it was essential to perform surgery. But the question was how to go about it, he added. He had consultations with his colleagues and also his seniors at NIMHANS. He spoke to Dr. Sengupta, a neurosurgeon in the Newcastle upon Time Hospital in England, under whose guidance he had taken up studies. Photographs and other material were sent, consultations were held and a plan for the delicate operation was finalised.

A team comprising Dr. M.S. Bembalagi, anaesthetist, Dr. Anil Desai, Dr. Srinivas, Dr. Ishwar and Dr. Duggani used a high- powered microscope for magnifying the nerves, and was able to take out the growth.

The extra limb which was taken out consisted of a shoulder blade, forearm, and a palm with a thumb and an index finger, all weighing around one kg. ``Though it looked like a mass, there was extensive growth inside,'' Dr. Duggani said.

Dr. Bembalagi said that as the anaesthetist, he had to keep in mind that the patient could not extend her neck. He also had to ensure that the air passage was open. However, fortunately for the patient, she had no other abnormality apart from the extra limb. ``This was quite reassuring for us,'' Dr. Bembalagi said.

A surgery would have been less complicated had the patient sought medical assistance earlier, Dr. Duggani said.

The patient, who was discharged from the hospital on Saturday, was grateful to her doctors. So were members of her family, including her husband. ``I was quite nervous when the operation began,'' she said. ``But, when I opened my eyes after the operation, I could speak and recognise others immediately,'' she said. The words of the doctor -- ``You are all right. You can open your eyes now'' -- were pleasing to her ears, she added.

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