Sixty-three year old Donald is having surgery to remove a large sarcoma – a type of cancer – in the thigh.
Donald first noticed the lump on his thigh one evening when sitting outside: “I noticed the lump on my leg when I was sat on a garden bench outside. I felt around my thigh and there was a lump. It was about the size of half a golf ball.”
Donald wasn’t bothered about the lump at first, until the word cancer was mentioned.
The growth on the back of Donald’s leg continued to grow three or four times in size: “On a night, trying to lay in bed it is a different pain but the main pain is stabbing, it really shakes you. This thing will eventually take over and kill me”
In this episode, we follow Donald’s surgery, as the sarcoma is removed by consultant orthopaedic surgeon: “Donald’s sarcoma is misbehaving and growing quickly. We need to get in there and remove it fast.”
Milton will dissect the muscle in Donald’s leg and carefully remove tumour completely, whilst maintaining the sciatic nerve.
The operation to remove Donald’s cancer, could take up to 9 hours for Milton and his team.
Margins are key to a successful operation, Milton will remove the tumour and a cuff of normal tissue, so no cancer cells are left in Donald’s leg.
Milton uses a new cutting edge technique to pin-point the spread of the cancer cells, injecting Donald’s sarcoma with a dye to make it glow, as Milton explains: “The lump itself with the cancer cells will retain the dye – the molecules will glow.”
When Donald’s sarcoma was first scanned it was the size of a navel orange, three weeks later it is a size of a honeydew melon. Due to the size of Donald’s sarcoma, removing this will leave a very large hole in the back of Donald’s leg.
The team work hard to preserve as much of the leg as possible. Fellow plastic, reconstructive and sarcoma surgeon, Maniram Ragbir, is on hand to rebuild the leg using fat, tissue and skin from the other thigh.
The clock starts once the tissue is removed, it can only survive 90 minutes without a blood supply so the pressure is on.
Luminous dye is used to show the blood flow in new transplanted flap, it is important to make sure the blood supply is connected, as Milton explains: “If a corner here or there it will die if there isn’t blood flow. It will go black and turn nasty.”
Donald’s sarcoma is successfully removed. He is home and starting to walk again with crutches.
