On March 26, 2019, the first two-stage hepatectomy was carried out, associating a section of the liver with a portal vein ligation, that is, achieving a complete removal of a tumor without triggering further complications, in two different stages, taking advantage of the benefits offered by the liver.
Mobilizing a group of specialists led by the Hepatobiliary Surgery and Liver Transplant Service of the Medical Center; Dr. Juan Manuel Rico and his team performed this surgery using the new modified technique called “Mini Alpps” that adds innovation to liver surgeries performed in Colombia and the world.
The surgery consisted of significantly reducing the dissection of the tissues, sectioning very little of the liver and with a much smaller incision, which reduces the risks of complications, facilitating the patient’s recovery, says the specialist.
The surgical intervention was based on the magical ability of the liver to hypertrophy, that is, to make the muscle grow, recovering its volume and function after an injury. This made it possible to carry out an operation that was actually two; where in the first one a section of the liver tissue was performed on the patient Carlos Guerrero, 69 years old, and in turn the portal vein that goes towards the tumor or towards the side of the diseased liver was obstructed or tied, understanding the portal vein as a thick blood vessel that carries blood from the gastrointestinal tract to the liver for nutrients to be metabolized.
This first phase was performed laparoscopically for the particular case of the patient; and in a second time, an average of nine days later, the side of the healthy liver increased so much in size that a removal operation called major hepatectomy.
This intervention is designed to be able to resect tumors that occupy a large volume in the patient’s body or have metastases in multiple places and whose healthy liver segment is very small. It is also possible to help patients who have been perceived as initially unresectable and who are offered a palliative alternative, says the specialist of the Medical Center.
It should be taken into account that not all patients are candidates; In the words of Dr. Juan Manuel Rico, the patient must be able to withstand two operations in less than two weeks, in addition to having an extraordinary multidisciplinary team that provides his experience and knowledge, allowing for successful interventions.
To carry out this type of intervention, a group of professionals participated, made up of physical therapists, nutritionists, infectologists, anesthesiologists, hepatobiliary surgeons, intensivists, expert instrumentalists, nurses, circulators, radiologists, among many other disciplines.
The patient Carlos Guerrero, had been looking for a solution to his pathology for a long time, had been urgently evaluated in a Clinic in Bogotá; without obtaining alternatives that would bring a cure or treatment for his problem, which increased his uncertainty and his little strength to live, finding that his illness had no way to be controlled or intervened.
To get to Medical Centerthe desire to live welcomes him, finding that there was a possible option for the management of his disease, also counting on innovative and technological surgical applications that allowed the group of health experts to carry out this great challenge.
“The evolution that the patient has presented is favorable, successfully recovering liver function completely after the intervention. He is currently at home with normal post-surgical controls, it should be noted that the prognosis of these patients without surgery is not good in most cases, and the intervention generates the possibility of long-term survival in some patients. We hope that our warrior of life continues to improve his health; regularly attending outpatient check-ups and performing resonance-type images every six months accompanied by laboratory tests; gaining quality of life with activity and complete functionality”, assures the specialist.
Currently, the Medical Center has innovative technology for this type of surgical challenges, as well as a multidisciplinary team of specialists and professionals dedicated to this type of patients, taking into account that, from their different roles, working as a team, they manage to carry out successful pioneering interventions in the Valle del Cauca and Colombia; adding prestige and recognition to the Institution, as well as new surgical possibilities that help improve the quality of life of patients suffering from said pathology.
The group of surgeons is specialized in different countries of the world, gaining experience in centers of great volume and logistic capacity, which has allowed introducing these techniques in Colombia and implementing them in the Institution, allowing users, clients and patients; have within your reach, innovative surgeries, performed under the highest quality standards, highlighting the differentiating seal of service vocation and excellence.
The Medical Center highlights and recognizes the work of the group of professionals and specialists who participated in this successful intervention; Bearing in mind that joining forces is the key to developing these highly complex cancer surgery and transplant programs; opening the space to talk and discuss complex cases with knowledge and experience to clinical physicians and surgeons, thus maintaining the margin of safety and avoiding the error that may occur when carrying out the work independently, emphasizes Dr. Juan Manuel Rico , specialist in Transplant Surgery of the Institution.
“It’s ultimately like directing a big concert having the best instruments and the best artists on the scene; managing to present a valuable piece, deserving of admiration and recognition” affirms the specialist.
Less than 100 registered cases of this procedure have been carried out in the world, and today Valle del Cauca becomes the first department in Colombia in the place where new life opportunities are offered to patients with procedures carried out under the highest quality standards in the world; with a group of specialists willing to give everything, and with even greater reasons when hope is gone, becoming true heroes of life.
The commitment of the Medical Center continues, never stops; every day the forces are renewed and successful cases arise, this being the result of work with clear objectives, with united forces always working under the premise of preserving life, making a difference with the vocation of service attached to the assistance collaborators , developing safe practices focused on quality to provide care and a world reference service.