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Successful rectus resection and abdominal wall reconstruction using an artificial graft

Ms. L.P.H, a patient from Binh Thuan province, was suffering from persistent abdominal pain, digestive disorders and loss of appetite caused by a large tumour occupying most of her lower abdomen. However, if she went underwent a surgery to remove the tumour, she ran the risk of damaging her digestive and respiratory systems – even a small cough could cause her small intestine and large intestine to stick out.

Six months after having a caesarean section, Ms. L.P.H, a patient from Phan Thiet, Binh Thuan province, discovered that her incision appearing to be protruding from her body and suffered from persistent abdominal discomfort and loss of appetite due to feeling bloated. When she visited hospital for examination, the doctors discovered a tumour in her abdomen located right below the lower rectus (the rectus abdominis muscle, also known as the “abs,” is a paired muscle running vertically on each side of the anterior wall of the human abdomen). Ms. H found that her belly was become increasingly larger, and she could even feel a shuffling sound inside. Sometimes, she felt that her belly was sticking out, “as if there was something living in there” and felt extremely frightened.

Ms. H’s worsening health and fright gradually made her more exhausted and emaciated. Her family was very worried but could not do anything because all of Ms. H’s doctors refused to perform surgery as the tumour was located right below the lower rectus. As this is the protective wall for the internal organs, a tumour resection would mean demolishing this wall and threatening the respiratory and digestive systems, which could eventually lead to death.

She was losing all hope when she happened to read about many successful surgeries on gastroenterological tumours located in dangerous positions in the abdominal cavity that had been carried out by Dr. Pierre Joseph Dumas at FV hospital. She rushed to the hospital in the hope of improving her situation.

After performing an examination and taking an X-ray and CT scan of Ms. H’s internal organs and tumour biopsies, doctors found the tumour cells to be between malignant and benign. They ascertained that the tumour were suppressing the small intestine, large intestine and colon and could soon cause intestinal rupture and death. Immediately, Joseph Dumas, PhD, joined with Dr. Nguyen Ngoc Son from FV’s Gastroenterology Department and Dr. Le Duc Tuan from the General Surgery, Thoracic and Vascular Surgery Department to conduct a multidisciplinary consultation to determine a treatment protocol to treat the tumour while protecting the digestive and internal organs.

After consideration, Dr. Dumas concluded that the best treatment was a complete tumour removal by surgery. In addition, the reconstruction of the abdominal wall using Ms. L.P.H’s own tissue muscle combined with an artificial graft would protect and ensure the proper functioning of the internal organs. He believed that the artificial mesh graft, when combined with the patient’s own tissue, would help to minimise pain, ensure there was no intestinal adhesion and accelerate rectus reinvention.

Dr. Dumas performed the surgery in collaboration with Dr. Le Duc Tuan of FV’s General Surgery Department. During this surgery, the doctors discovered that the tumour was 30 cm by 20 cm in size. It occupied almost all of Ms. H’s abdomen from the chest to the pubis and was suppressing most of the small intestine, large intestine and left and right colon, causing inflammation and an adhesive condition which complicated the dissection process. Dr. Dumas and other doctors decided to split the tumour, performing the surgery with great care and skill so as not to adversely affect the patient’s other organs.

After the tumour resection was complete, Dr. Dumas used a part of the pelvis muscle combined with a special artificial mesh graft to connect the abdominal wall muscles and prevent intestinal adhesion to the muscles. The most difficult aspect of this technique is connecting the artificial graft so that all the blood vessels function properly so that there is no necrosis. This can only be achieved by skilful surgical manipulations. Thanks to Dr. Dumas’s professional experience and the support of the surgeon team, the five-hour surgery was a great success.

Three days after surgery, Ms. H felt much less pain in her abdomen and could eat normally. She had no more loose stools and was able to breathe normally. Three months after surgery, the patient has almost fully recovered. She has returned to her normal life and can eat all the foods she loved to eat before.

RECEIVE SURGICAL TREATMENT FOR GASTROENTEROLOGICAL DISEASES AND CANCERS WITH DR. PIERRE- JOSEPH DUMAS

If you are suffering from problems such as digestive disorders, constipation,gastro-oesophageal reflux, flatulence, dyspepsia, or even more severe problems such as gastric ulcers with bloody vomit and bowel movements, gastric cancer, oesophaegal cancer, hepatobiliary cancer, pancreatic cancer, colorectal cancer, gastrointestinal cancers, gastrointestinal diseases or rectum and anus diseases, it is important that you seek examination early in order to receive timely treatment.

If you or any of your family members are affected by one of the above diseases and you would like to seek consultation and treatment from Pierre Joseph Dumas, PhD, a leading specialist in thoracic, vascular and gastroenterology from France, please contact FV’s Hepato-Gastroenterology Department by calling (08) 5411 34 66 (ext. 1250) from 24th February to 20th March 2014, or make an appointment online by clicking here.

HEALTHY LIVING PUBLIC SEMINAR “Gastrointestinal diseases and gastrointestinal cancers: early screening, precise diagnosis, thorough surgery and comprehensive treatment”

For more information, please call (08) 5411 3333 – ext. 1336 to register for the Healthy Living public seminar “Gastrointestinal diseases and gastrointestinal cancers: Early screening, precise diagnosis, thorough surgery and comprehensive treatment”

Time: 9:00 AM to 11:30 AM, 1st March 2014.

Location: Conference room, Continental Hotel, 134 Dong Khoi, District 1, HCMC.

When attending this seminar, you will have the chance to receive consultation from Dr. Pierre-Joseph Dumas and other specialists from FVH’s Hepato-Gastroenterology Department.