A 46-year-old man, bedridden for two years, is now able to walk again after undergoing surgery for the removal of a 14-kg swollen mass that had been hanging from his left thigh, doctors said today. Saidalavi, hailing from Kerala's Thrissur district, suffered from lymphedema - a crippling condition involving the collection of body fluid in any part of the body - leading to its abnormal enlargement and eventual disability. The operation, lasting for more than five hours, was performed recently by a team of five surgeons and three anaesthetists at Amrita Institute of Medical Sciences here. The hospital removed the swollen mass, weighing 14 kg, it said in a statement. Subramania Iyer, head of plastic and reconstructive surgery at the hospital, said: "It was a complex surgery. First, we treated him for four weeks with intensive antibiotic therapy to control infection in his legs. Then, the challenge was to institute Comprehensive Decongestive Therapy (CDT) which plays a major role in preparing a lymphedema patient for surgical treatment." In Saidalavi's case, this went on for a month and involved Manual Lymphatic Drainage (MLD) and a special method of bandaging to make the legs softer by pushing the accumulated fluid to other parts of the body, he said. "Finally, his leg was ready for reduction.
It was a challenge for anaesthetists to manage the big excision in such an overweight patient. His physical transfer to the operating table and correct positioning during surgery was also difficult and required meticulous planning," Iyer said. India has a large number of lymphedema patients. The incidence is high mostly due to lymphatic filariasis(elephantiasis), a tropical infection with the filarial worms transmitted through mosquito bites, the hospital said. Mohit Sharma, professor, department of plastic and reconstructive surgery at the hospital, said: "Lymphedema is a major health problem in India, next only to malaria." "Lymphatic filariasis patients are mostly poor and marginalised, and suffer mental, social and financial losses, leading to life-long stigma and poverty," he said. "He (Saidalavi) will need further reduction surgery on both the legs after 6-9 months, and then he will be able to lead a normal life," Iyer said.