A Risk Worth Taking

University Hospital Southampton is one of the country’s leading medical centres, where surgeons and their patients take calculated risks and face challenging lifesaving operations.

Consultant spinal surgeon Michael Quaye and consultant urology surgeon James Douglas are joining forces to perform a two-day operation that they’ve never attempted before.

Their patient is 27-year-old George, who has previously been treated for testicular cancer. However, since then, he has developed a tumour deep in his body that’s invaded the spine and attached itself to the aorta, the body’s biggest blood vessel. The surgeons have yet to establish if the tumour is cancerous.

Surgeon Michael will operate on George’s spine on the first day of the two-day operation, when he must remove most of one of George’s vertebra without disturbing the nearby spinal nerves. Any damage to these could leave George paralysed. But previous surgery has left scar tissue around George’s spine, making it difficult for Michael to identify and protect the nerves.

On the second day of surgery, consultant James will operate deep in George’s abdomen to take out the remaining sections of tumour attached to the aorta. If he damages this artery, it could result in a fatal bleed. But the aorta is not James’ only challenge, as the tumour is also attached to the ureter, the tube which carries urine from the kidney.

High risk surgery is also on the agenda for consultant thoracic surgeon Alessandro Tamburrini. His patient, 49-year-old Nigel, has a tumour in his lung that doubled in size in just five weeks. It’s in the right upper lobe of the lung and is now pushing into the rib cage.

First, Alessandro will need to cut out a 10cm-by-10cm section of rib and the corresponding muscle that have been invaded by the tumour. Then, he must detach the upper lobe of lung from the pulmonary veins and arteries that connect the lung to the heart. If he damages any of these it could result in a life-threatening bleed.

But as Alessandro starts the operation, he thinks that the cancer has spread further into Nigel’s lung to the middle lobe. This would mean a much bigger and longer operation that would leave Nigel with severely reduced respiratory function.