Rare Surgeries

Rare Surgeries
If shows like House M.D. or ER have taught us anything, it’s that gift-wrapped medical mysteries with happy endings appeal to the public -- regardless of the story’s reliance on fact or “real” science. Step aside Hollywood, the following are a few exciting and rare surgeries. Unlike their made-for-TV spin-offs, however, these rare surgeries are real.

5 rare surgeries

1- Full face transplant

For 24 years, 30-year-old Frenchman Pascal Coler lived in silent agony on account of a genetic condition (neurofibromatosis) that turned him into a modern-day Elephant Man. The ridicule that his disfigured face drew in the streets became so severe that it forced him to live as a recluse and as a prisoner to his condition. Thanks to the courage to perform rare surgeries like face transplants, Coler no longer has to live in society’s shadows.

After 16 hours of surgery in March 2008, Mr. Coler emerged with new lips, cheeks, a nose, a mouth, and a smile. The remarkable procedure -- undertaken at Henri-Mondor Hospital in Creteil, France -- was hailed as the first full face transplant.

"At first we were quite frightened to do the transplant," said Dr. Laurent Lantieri, head of plastic surgery at Henri-Mondor. "We didn't know how the patient would tolerate the fact to have a new face." The result, however, was a tremendous success. The transformation is simply incredible and Coler said that "The operation has revolutionized my life. I can live as a normal human being for the first time."

How rare: Coler’s full face transplant was the first of its kind.

2- Six-way kidney transplant

What do doctors do if they have a patient in need of a kidney, a friend of the patient who is willing to donate, and incompatible tissue types? Welcome to modern medicine’s answer to musical chairs: the six-way kidney swap.

In April 2008, nine surgical teams at Johns Hopkins Hospital performed the world's first six-way, simultaneous and "domino" kidney transplants. Five of the six patients requiring transplant had willing donors who unfortunately didn’t match their tissue type, but did match that of another patient’s. An independent sixth donor was thrown into the mix, resulting in the now famous six-way swap. Simultaneity was required in order to prevent donors from backing out once their friend or loved one received a kidney.

Johns Hopkins Hospital has carried out a number of simultaneous transplants over the past three years, but this was the first six-way.

How rare: As rare surgeries often are, this was the first of its kind.

3- No-incision appendectomy

Appendectomies used to result in a week-long hospital stay and a large scar. Now, due to experimenting with rare surgeries, lucky appendectomy patients can expect to have their appendix removed through -- brace yourselves -- the vagina or anus. In March 2008, surgeons at the University of California, San Diego (UCSD), removed 24-year-old Diana Schlamadinger’s appendix through her vagina. Despite the horrific images this conjures, the surgery offers immense benefits in both recovery time and in pain reduction.

We may have fibbed a little when we called this a no-incision procedure as it require a small incision in the inner wall of the vagina (if you have one) and one more just below the belly button to allow the insertion of a camera to guide the operation. Within two days after the surgery, Diana (a student at UCSD) was recovering with almost no pain. "I feel kind of like I did too many sit-ups," she said.

How rare: This surgery was the first of perhaps many.

4- Nerve transplant

After her son, Nick, had his hand paralyzed in a serious car crash, like any loving mother, Frankie Anderson-Harris wanted to help. On November 17, 2005, Frankie donated nerves from both her arms and legs to give her son’s hand new life. Her nerves were used to rejoin those that were severed in her son’s forearms. After the extraction, Frankie was left with numb spots on her feet and elbows; she was told that these sensations would dissipate over time. The surgery was completed successfully, but, as with any transplant surgery, there was fear that the host would reject the donor tissue. Nick was told he’d have to take immunosuppressive drugs for at least a year following the operation, after which point his body hopefully would have accepted the new nerves. "Sometimes you feel very, very helpless and it's nice to be able to do something," Nick’s mother said. "I was glad to be able to do it."

How rare: This rare surgery was one of only a dozen ever attempted at the time.

5- Robotic brain tumor removal

In May 2008, 21-year-old Paige Nickason had a tumor robotically removed from her brain. Using remote controls and an image screen, doctors at Foothills Medical Centre in Calgary guided a two-armed robot -- known as NeuroArm -- through a nine-hour procedure to remove the young woman’s tumor.

"Paige’s brain surgery represents a technical achievement in the use of image-guided robotic technology to remove a relatively complex brain tumor," said Dr. Garnette Sutherland, professor of neurosurgery at the University of Calgary and Paige’s surgeon. Interestingly, Dr. Sutherland attributed, at least partially, humankind’s development of manipulative robotic surgery techniques to popular video games. "We would all agree that our young children who have become immersed in video games represent the future generation of surgeons," he said.

The robotic arm that was used in Paige’s surgery was built in collaboration with engineers from MacDonald, Dettwiler and Associates, known for creating the International Space Station’s Canadarm and Canadarm2.

How rare: This rare surgery was the first of its kind, ever.
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