FIRST MAJOR LIVER SURGERY IN UVA PROVINCE
Hepatobilliary surgery is still at the infantile stage in Sri Lanka. Only a handful of surgeons in the professorial units are able to perform this safely. Because of the risk of torrential bleeding an instrument known as the harmonic scalpel is used during liver resection. Liver surgery using the conventional diathermy instead of the harmonic device is seldom attempted.
Provincial General Hospital Badulla being a peripheral general hospital do not possess a harmonic device.
We sent few of our patients to Colombo but in the majority no surgery was attempted. Therefore we decided that surgery without the harmonic device should be the only option as that would promote liver surgery in Sri Lanka among the peripheral surgeons.
Dr. D.C.A.Thewarapperuma and his team performed a left hepatic lobectomy on a 49 year old female patient from Mahiyanganaya. The patient had a hepatoma involving the segment ii of the liver.
The tumour was approached via a subcostal incision and selective vascular isolation done . The entire left lobe (segments i,ii & iii) of the liver was then resected with spray diathermy.
The total blood loss was 500ml and the time taken for surgery was 2.5 hours. The recovery phase was uneventful.
It would have been a cakewalk if we have a harmonic device to carry out this surgery. The latest equipment is called the “Enseal” and it costs around 2.5 million rupees.
We sincerely hope a kind donor to help us to promote liver surgery in Sri Lanka