Trust one of first to perform innovative new breast surgery

North Tees and Hartlepool NHS Foundation Trust is one of the first to have performed breast surgery with the patient completely awake with a special type of nerve block injection.

The trust now carries out breast surgery under nerve block injections for those who are not fit for having a general anaesthetic.
img_6872Marlene Webster, who is 69 and lives in Stockton, was diagnosed with breast cancer last year and told she needed a mastectomy. Marlene suffers with very severe COPD (chronic obstructive pulmonary disease) and is on home oxygen, which made it too high risk for her to have surgery under general anaesthetic.
But due to the COPD, the routine type of nerve block procedure normally carried out for breast operations with local anaesthetic could also not be used.
Consultant anaesthetist Ramkumar Dhanancheyan said: “Normally we would inject into the patient’s back which would block the nerves in the area we would be operating on.
“However, Marlene’s severe COPD meant this wouldn’t have been safe to do so, because there’s a risk with the injections near spine that her breathing would get further worse during the operation with doubtful recovery. Instead, we had to carry out multiple specific nerve block injections on the chest wall under ultrasound scan to spare most of the breathing muscles. This would assure safety and the operation being done with total numbness of the breast while being completely awake.
“We are very proud to be one of the first trusts to perform breast surgery completely awake under these specific nerve block injections for patients with very significant medical conditions.”
Consultant breast and endocrine surgeon Matei Dordea said: “Patients don’t like the idea of being awake and conscious during an operation. It is however safe, particularly for patients who have other major health issues, with the added benefits of quicker recovery and no side effects from general anaesthetic.’
“We now have the expertise to help patients like Marlene who previously would never have been able to undergo surgery because they are too unwell. It’s a fantastic achievement for everyone involved at the trust.”
Dr John Francis, clinical director in anaesthetics, said: “We are absolutely delighted with the results and it is a collective team effort including the pre-operative assessments unit, theatre staff and the surgical department. Use of technology allows us to broaden our knowledge, skills and our ability to help patients like Marlene.”
Marlene, who has three grandchildren and a great grandchild, stayed in overnight at the University Hospital of North Tees as a precaution but felt fine after surgery.
She said: “The operation went absolutely brilliantly – there was no pain and no soreness.
“I stayed in hospital overnight as a precaution because of my COPD, but I felt fine almost straight away. It’s amazing how medical developments like this can help people like me.”

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