Himachal Pradesh has achieved a great success in the field of medicine. The Plastic Surgery Department of the Atal Super Specialty Medical Sciences at the capital Shimla first prepared a jaw by taking out the bone from the feet of a patient using the 'Free Fibula Flap' technique. It was not only a difficult surgery from technical terms, but this success also shows that now even in a hilly state like Himachal, high-end micro-sermary facility is being available for patients, for which earlier patients had to go to big institutions like PGI Chandigarh or Delhi.
Actually, the main Kiardar in this story is 53 -year -old Vikram Singh, a resident of Tharot in Kangra district. He had cancer a few years ago. Vikram Singh told that in the year 2016 I had a tongue cancer, at that time it was treated. It was thought that everything was over now, but after a few years when toothache and it was removed, the infection spread there. This infection gradually eaten the jaw bone completely. In 2024, the dental department fired a jaw of about 5 cm and a metal plate was installed there, but the problem did not end. The patient's wife said that in the initial treatment, the husband's tongue surgery was performed and then radiotherapy was given. The situation was normal for a few years, but after radiotherapy, the jaw bones weakened. The metal plate installed out of the infection's jaw bone began to appear from outside, from there, the pus kept coming, and there was a problem in opening the mouth, eating food and breathing. In view of the critical condition, the surgery of Atal Super Specialty Hospital had decided to surgery.
Doctors remove the bone from the leg free Fibula Surgery
In view of the patient's condition, the Department of plastic surgery, dental surgery and anesthesia jointly prepared a multi-disciplinary board. Surgeon Dr. Rajesh Kumar, who was part of the team of surgery, said that 'Free Fibula Flap' surgery is technically very sensitive. In this, the bone is extracted from the leg. There are two bones in the leg. We can remove the thin bone which is called Fibula. Fibula bone is considered the most suitable for this surgery. Its biggest feature is that it is a thin, long and flat bone, which can be easily molded into a U-shape. Just like the human jaw is designated. In addition, Fibula has its own independent and vascular supply, so that it can be kept in many pieces and keeping its blood supply. This is the reason why doctors can give it the desired shape.
Dr. Rajesh Kumar, Plastic Surgeon, AIMSS (ETV Bharat)
How is free phibula surgery
Dr. Rajesh Kumar said that 'two veins have to be taken together while removing this bone. These veins are very fine. In the microscope, they look slightly large size. We took the Fibula bone with the veins, we also took a skin from the leg to replace the skin of the damaged throat. We then shaped the bone and fixed it with the jaw bone and combined the veins taken with the bone with the blood drugs going into the neck. It is a very difficult process to add veins to this process. The entire surgery could have failed if the blood flow was not done properly, but the team of doctors efficiently added three major nerves to the neck successfully, and the blood circulation started smoothly. This surgery lasted for nine hours.
Pre Fibula Surgery
The main things of surgery were cut into the required length (about 7 cm).
He was also taken with two micro -blood vessels and a part of the skin.
The bone was molded into a U-shape and fitted in place of the jaw.
A microscope and surgical loop were used to connect the veins to the neck veins.
Also, the bad skin of the throat was also changed with the skin of the leg.
Why do doctors remove Fibula bone
Dr. Rajesh Kumar said that the removal of the Fibula bone does not affect the functionality of the foot, because even without Fibula, a person can run normally. This is why surgeons do not hesitate to remove it. Not only this, the skin around Fibula can also be easily transplanted together, so that if the patient's throat or facial skin is also damaged, then its skin grafting is also possible in the same surgery. After surgery, Vikram Singh was kept in ICU for 2 days, where every action was monitored. From there, when his condition became normal, he was shifted to the surgical ward. On the 10th day of the operation, they are eating food without any problem, are able to talk and have come in a position to live a normal life.
Improvement in patient's condition
After the successful operation, the patient Vikram Singh's eyes clearly showed satisfaction, gratitude and the glow of new life. Vikram Singh said that when the doctors said that now the bone of the jaws will have to be removed. Had thought that now it would be over to drink food throughout my life, but when I was told that the doctors have made the jaw by taking a bone from my leg, and I am able to eat myself with my mouth now, I see that I have got a new life. When the ICU regained consciousness and the doctors said that everything has become successful, then tears came in my eyes. I am thankful to the entire team of Atal Hospital. If these doctors were not in Shimla, I would have to go out to another state for treatment. Now it seems that God wrote my rebirth in these hands. "
When does this surgery need to be removed after the tongue or jaw cancer.
The jaw becomes weak after radiotherapy.
After extracting the tooth, the bone melts with infection.
After severe accident or trauma, the jaw breaks down.
News of relief for Himachal patients
Earlier, patients were referred to PGI Chandigarh or AIIMS Delhi for such complex surgery. This not only delayed treatment, but also increased the economic burden a lot. Now this surgery is possible in the Atal Super Specialty Institute, which is a big relief for the people of the state. Dr. Rajesh Kumar says that, "Our aim is that such facilities of treatment are available in Himachal, where patients do not have to go out. Now if someone's jaw is spoiled by cancer, infection or trauma, we can rebuild it here."
Patient's successful free Fibula Surgery
These doctors join
These operations included the team of Plastic Surgery Department, which included Dr. Nitin Kashyap, Dr. Rajesh Kumar, Dr. Nipun Sharma, Dr. Pushpinder Singh, Dr. Rangila Ram's team from Dental Surgery, Dr. Vikram Turn from Anesthesia Department, Dr. Manoj Matan and Dr. Ravikant Dogra's team in ICU. This surgery is a milestone for the plastic surgery department and the entire institute. This will give new hope to those patients whose jaw has been affected after cancer, injury or radiotherapy. Now patients will not have to go out of the state to treat such disease.
