Rare thumb reconstruction surgery performed in Nashik

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Nashik, Feb 24 (UNI) In a rare surgery performed in the city by renowned Plastic Surgeon Dr Rajendra Nehete, both the thumbs of a patient were reconstructed by transferring the second toes from both the feet.

Manohar Shisode (25), a factory worker at Satpur MIDC area here, met with an accident on January 21 in which he lost both his thumbs. They were crushed in a punch machine.

He was taken to Dr Nehete's Plastic, Cosmetic&Hand Surgery Hospital at Mumbai Naka, here. Dr Nehete, who has seen several patients with chopped-off fingers, thumbs and hand for the first time in his career, had met a patient with bilateral thumb amputation.

After an initial examination, he informed Manohar that none of his thumbs could be rejoined as they were badly crushed in the punch machine. He, however, informed Manohar about the possibility of reconstruction of both thumbs by transferring the second toe from both the feet.

After discussion with Manohar and his relatives, Dr Nehete planned the surgery.

According to Dr Nehete, the surgery, wherein the toe is transferred to the place of the amputated thumb, requires immense planning and needs to be performed under the supervision of eight to nine skilled surgeons. After removal of the second toe the foot is reconstructed in such a fashion that it does not leave any deformity or disability.

During the surgery, at first the toe is dissected with the bone, tendons, nerves and the blood vessels from the foot. Then the hand is prepared to receive the toe. The live transfer involves joining of the bone, two tendons, four nerves, two veins and one artery under a microscope with high magnification.

Manohar was operated upon on January 23 for nearly nine hours for the reconstruction of his right thumb using the second toe of his left foot. He was given a special type of anesthesia called Combined spinal&Epidural Anesthesia on second toe and Brachial Block anesthesia for the hand. He was awake and completely pain free throughout the surgery, Dr Nehete informed.

In post-operative period, the first five days were crucial since there is a possibility of the blood vessels getting blocked leading to a failure of surgery. It required close monitoring by the doctor to prevent and detect such eventuality. However, after five days, Manohar was very happy when his surgery was declared 'successful'.

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