On September 4, 2022, two passengers including Tata Sons chairman Cyrus Mistry died in an unfortunate car accident. Two other passengers, Dr Anahita Pandole, who was driving the Mercedes, and her husband Darius Pandole were severely injured in the car crash.
Reportedly, Dr Pandole was operated on Thursday for a pelvic reconstruction by a team of over 20 doctors at Sir HN Reliance Foundation Hospital. Experts from around the world including USA, UK and Europe provided insights for the procedure.
Dr Tarang Gianchandani, CEO, Sir HN Reliance Foundation Hospital said, “With team of 20-plus multi-disciplinary experts, we have been monitoring the condition of Dr Anahita closely for the last 11 days before planning any surgical intervention. Pelvic surgery was concluded today morning with precise techniques, clinical skills and modern technologies. This will enable her to achieve the recovery of the injuries caused post the traumatic accident. I am grateful to our surgical teams and for the advisory provided by Dr Peter V Giannoudis."
"The team that conducted the surgery includes Dr Vaibhav Bagaria, Director, Department of Orthopaedics, Dr Dilip Tanna, Mentor Orthopedics, Dr Darius Soonawala, Consultant Orthopedics and senior anesthetist Dr Daisy along with trained nurses and technicians,” added Dr Gianchandani.
What is reconstructive pelvic surgery?
A reconstructive pelvic surgery helps in building vital pelvic organs including the bladder, vagina or pelvic floor, which may have been removed or damaged after gynecology surgery or during cancer treatment.
In Dr Pandole's case, the gynecologist suffered a traumatic hemipelvectomy, which involves a pelvic fracture. It is a rare type of pelvic fracture that is characterized by the wide separation of the innominate bone from the pubic symphysis and sacrum, the avulsion of the external iliac vessels, and the severe stretch injury or disruption of the femoral and sciatic nerves, as defined by a 2013 study by the US-based National Library of Medicine.
“The incidence of traumatic hemipelvectomy is rare, but it is a devastating injury. Recently, an increasing number of patients with traumatic hemipelvectomy are admitted to trauma centres alive due to improvements of the pre-hospital care. Successful management requires prompt recognition of the nature of this injury and meticulous surgical technique," the study further adds.
That said, a reconstructive pelvic surgery is said to restore organs to their original position.
Dangers during a traumatic hemipelvectomy and how it can be overcome
The study highlights, “The leading causes of death in patients with traumatic hemipelvectomy are blood loss, infections and multiple organ failure. The successful rescue of these patients depends on the following key steps: First, hemorrhage control and vigorous resuscitation. Direct clamping of the large bleeding vessels should be the first step in resuscitation. It has been acknowledged that circumferential compression with a sheet is a cost-effective method of hemostasis. Wrapping the circumference of the pelvis with sheets and knotting in front of the pelvis can form a wound compression bandage that is effective in controlling bleeding in cases with a complete separation of the injured limb from body. However, this method is sometimes less than ideal for circumstances in which the injured limb is still partially attached to the trunk. In such cases, hemipelvectomy is a life-saving intervention. It has been reported that the early angiography and subsequent embolisation should be considered in cases of continued unexplained blood loss.”
What is traumatic hemipelvectomy?
Dr Pandole had traumatic hemipelvectomy. It happens due to a severe fracture of the pelvis due to a high trauma event such as car accident. What is pelvic reconstructive surgery?
This surgery is very case specific. It could be done in cases that involve amputation, debridement, haemmhorage control, bone re-alignment or reconstruction with implants and wound closure. Is it only a single surgery?
No, there could be multiple surgeries involved. It is again case specific.
