Gleneagles BGS Hospital Performs Complex Scapulectomy and Reconstruction on Nigerian Medical Student
Bengaluru: Gleneagles BGS Hospital recently undertook a challenging case involving a 22-year-old medical student from Nigeria. The team performed a radical scapulectomy with synchronous radiotherapy and reconstruction using a thigh flap to treat recurrent chondrosarcoma of the scapula. The case was further complicated by the patient’s faith as a Jehovah’s Witness, which prohibited blood transfusions, necessitating meticulous surgical planning and execution.
The patient presented with a six-month history of a painful swelling on her right upper back, which limited shoulder mobility. Imaging confirmed recurrence of the tumour, involving extensive bone destruction but sparing neurovascular structures. A multidisciplinary team developed a coordinated plan combining surgery, radiotherapy, and reconstruction to address the complexities of the case.
Dr. Karthik K Prasad, Lead Surgical Oncologist, led the 14-hour surgical procedure. “Radical scapulectomy is rarely performed, and this case required extensive planning and meticulous execution to ensure complete tumour removal,” he said. The tumour, weighing 1.5 kg, was removed with frozen section analysis confirming clear margins. The patient was then shifted to the radiotherapy unit for electron beam therapy before returning to the operating theatre for reconstruction.
The patient’s faith added another layer of complexity, as blood transfusions were not an option. “Close collaboration and careful planning allowed us to manage the extensive procedure, achieving a total blood loss of only 500 ml,” Dr. Prasad added.
Dr. Ashish Shetty and Dr. Purneema, Consultant Anaesthesiologists, managed the patient during surgery and radiotherapy. “Post-surgery, the patient’s hemoglobin level was maintained with iron injections, strictly avoiding any blood products,” said Dr. Shetty.
The Consultant Radiation Oncologist emphasized the role of radiotherapy in reducing recurrence risk. “Administering targeted radiation directly to the surgical site significantly reduced the risk of recurrence. Radiotherapy also minimized blood loss by controlling oozing at the surgical site.”
Reconstruction was carried out by Dr. Naveen Kumar H R, Consultant Plastic Surgeon, who created a 40 cm x 25 cm free flap using thigh tissue. “Reconstructing such a large defect required precision to ensure both functional and cosmetic outcomes. The vascular anastomosis was critical for maintaining blood flow, especially given the restrictions on transfusion. It’s rewarding to see the patient recover with regained shoulder mobility and optimism for the future,” he said.
The surgery resulted in complete tumour resection, and the reconstruction enabled the patient to regain function and mobility in her shoulder. Now recovering well, she has resumed daily activities and plans to continue her medical studies. The patient expressed her gratitude, saying, “I am incredibly thankful to the entire team at Gleneagles BGS Hospital for their expertise and dedication. Their ability to meet my unique needs made it possible for me to look forward to a future full of possibilities.”
Dr. Jatinder Arora, Cluster COO at Gleneagles BGS Bengaluru, commented, “This case exemplifies the teamwork and expertise that Gleneagles BGS Hospital is known for. Handling complex cases with unique requirements highlights our hospital’s capacity to provide world-class care across specialities.”