Simultaneous surgeries save man’s life
When EMS wheeled the comatose twenty-three-year-old man into Seton’s Level II trauma center a few days before Christmas, he was in critical condition. He was bleeding from his abdomen, and a blood clot was pushing on his brain. Any extra pressure could have led to permanent—if not life-threatening—brain damage.
His injuries occurred when a driver ran a red light and hit him, recalls Dr. Glenn E. Harper, the neurosurgeon on the case. “Either [injury] would have been life-threatening had we not been able to [tend to] them in a timely fashion,” he says.
Dr. Harper and Dr. Drue Neelley Ware, Seton Medical Center Williamson’s director of trauma services, quickly assessed the situation. As they considered the blood clot, the doctors worried that if the patient’s blood pressure dropped too low, he’d go into shock from bleeding, which could worsen the brain injury. At the same time, the abdominal bleeding also needed immediate medical attention.
The accident victim needed two major surgeries. But which should take place first?
“In many large trauma facilities, they get the abdominal surgeries done first; but in that time you have this extra pressure on the brain that can lead to brain damage,” Dr. Harper says.
Not wanting to risk further injury, the doctors settled on a rare practice that they believed would give the patient his best chance for recovery: They would perform surgeries simultaneously on his brain and abdomen.
During his twenty-one years of experience—fourteen years in practice following a seven-year residency—Dr. Harper had seen one similar case, so he knew that simultaneous operations, though rare, were possible.
“Fortunately, it was the right time of the day; we had all of the right staff here, and they were able to give us two separate teams in the O.R.,” Dr. Harper says.
After placing a drape to separate the patient’s two different surgical sites, the surgeons got to work: While Dr. Ware worked on the man’s abdomen, Dr. Harper worked on his brain.
“How’s it going?” they’d ask each other, checking in on the progress of the other surgery.
“Instead of the common two-way conversation between the surgeon and the anesthesiologist, it was a three-way conversation among a surgeon, another surgeon, and an anesthesiologist,” Dr. Harper says. Counting the two surgeons, their teams, and the anesthesiologist, he estimates that eight or nine medical personnel were in the operating room during the joint surgeries.
The experience “was probably one of the best cases in point of how we’ve been able to get that teamwork to work so well,” says Dr. Harper, praising the Emergency Medical Services for getting the accident victim to the hospital so quickly and Seton’s emergency center team for promptly getting the right people on board. It was a perfect storm of fast action, exceptional teamwork, and stellar communication.
Three days after the surgeries, a Christmas miracle occurred: The patient awoke from his coma.
“We expected him to have a bit of a rough course, but in fact he woke up within about three days to be almost back to completely normal,” Dr. Harper recalls. By the sixth day, the man was in possession of his full faculties and was deemed ready to go home. He didn’t even need rehab.
Thinking outside the box isn’t new to Dr. Harper or his team at Seton. “We’re always on the lookout for ‘Is there something that can help the patients have a shorter recovery, get out of the hospital faster, back to daily activities faster, back to work faster?’ And I think that is kind of the holy grail for surgeons.”