13th July 1997


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Operation blue baby

In this new series Roshan Peiris will cover various surgical operations. Today
we publish a graphic description of a chest operation on a blue baby

OperationHe is a tiny morsel of a baby, just eleven months old. He was what is known as a blue baby or cyanotic baby, that is a condition where not enough blood goes to the lungs from a defective heart. All one could see of this little mite last week when he was under the scalpel was green cloth which wholly covered him, face and body. The breast bones had been cut and were open, held aside with surgical retractors.

How was he breathing? It was through a tube inserted in the trachea (tubes leading to the lungs) connected to a breathing machine.

The baby’s heart was palpitating hard as the able specialist Dr. P. A. Gooneratne worked carefully and with full concentration with scissors, surgical instruments and forceps. ‘Heperin,’ he would say "here is a difficult point."

The heart was defective in that the left ventricle was on the right and the right on the left among other defects. Suddenly the surgeon removed a fleshy piece, "this is the thymus gland," he explained. "I have no choice but to remove it, since it stands in the way of the major operation. Some think it is an important gland but it isn’t so."

With unshed tears, masked and gowned I think we all prayed to God for the wee one’s life. No one other than the surgeon hardly spoke for here exposed was a tiny human heart. The heart so connected with romance and poetry through the ages, is a sort of shapeless mass, purple and red combined and in one corner was a collection of blood.

"It does not look even remotely romantic," I muttered.

The surgeon heard me and laughed. "You can certainly say that, I don’t operate on romantic hearts. Certainly, I don’t do surgery on them." But all the while his expert hands worked relentlessly and urgently, while pop music played softly in the background.

"That music we operate to is pop, not Bach and Beethoven," and he began singing, his eyes always on the little infant cloaked in sterilized cloth.

The consultant anaesthetist hovered concernedly around as did the assistant anaesthetist Nilanthini Senanayake.

"Where is the Heperin?" the surgeon would say, "the breathing is not normal, ah now it is," he told Mrs. Savithri Wijesekera the consultant anaesthetist. There was a diatomy coagulation machine with electric current and the surgeon cauterised bleeding points. That is to ‘burn’ the bleeding ends to stop the bleeding. He also sewed parts with black silk thread.

A circular large lamp like a chandelier hung over the baby to give more light so that the surgeon could see every nook and cranny of this tiny human heart.

"In another one and half years he will stand surgery again since the total operation cannot be done at once. Also other needed corrections can then be done, before he is declared well. This operation, as you can see, is taking long, around three hours." It would help the baby get a fairly normal flow of blood to the lungs.

While I stood shivering the little purple hued heart kept palpitating, the only thing that showed there was life beneath those green surgery drapes. A square white surgical plaster surrounded the opening of the heart. The breathing machine in white stood in a corner, an ultra violet lamp on another side, this to keep the theater free of any type of infection.

The nurses were very careful to see that the cameraman and I had our heads covered and we were masked and gowned and wore special shoes and long pants all in green except for the shoes which were white.

When I left hospital and later inquired, the baby was safely back in the ward, the operation completed.

The Sunday Times thanks the Chairman of the Sri Jayawardenapura hospital Dr. J. B. Peiris, the Director of the hospital Dr. Lakshman de Lanerolle, the surgeon doctors and nurses for their help and co- operation enabling us to see this intricate operation on a human heart.

(Next week a cataract operation - with new techniques)

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