INTRAOPERATIVE PHOTOGRAPHS SHOWING THE ILIAC ARTERY RECOSTRUCTION ALONG WITH ILIAC VEIN TO IVC BYPASS WITH PTFE GRAFT.
What to do when a young patient aged 28 years comes to you with a glimmer of hope in his eyes?A rejected case from a couple of medical institutes around,it seemed he still had faith in God.Well we still are ordinary beings doing our bit to reach people and help them in every possible way through our services.
This gentleman came to us with history of left sided condrosarcoma of the iliac bone resected 2 years back at some other hospital with reconstruction of the left iliac artery.He had recurrence of the tumour extending into the pelvis and the left groin.He had massive swelling of the left lower limb of recent onset and his pulses were not palpable.He also had an old history of DVT of the same limb but was irregular taking anticoagulants.
A redo case is always a pleasant challenge esp.in a patient weighing 130 kgs.Its always a team effort of various specialities that helps in a challenging situation like this and I are fortunate to have in my company good young surgeons who think positively and aggressively and importantly enjoy each other’s success.
The tumour was resected in totality including a secondary lying in the left renal region.Iliac artery was reconstructed with a interposition graft as it was badly entagled by the tumour mass.Venolysis was done for the left Iliac vein and local thrombus was removed though it showed chronic changes. Since the limb was massively swollen with discoloration of the foot we deemed it necessary to do a bypass for this vessel and try our best to save the limb.We finally did a left iliac vein to Inferior vena cava bypass with a PTFE graft.
The patient is doing fine and the limb swelling has reduced remarkably.He is now on oral anticouagulation and both the Grafts are patent.
