Surgeon describes incredible 18 hour operation which transformed life of Peterborough grandad at Royal Papworth Hospital

“We did at one point think we might have to abandon the operation and put him back together in a worse state than he was originally,” recalls Aman Coonar, senior consultant thoracic surgeon at the Royal Papworth Hospital NHS Foundation Trust, who was part of the team which operated on the 59-year-old.

It had been 17 years since Kevin from Eastfield in Peterborough had seen his right lung removed to cure his cancer, leaving a hole in his chest wall which pus was streaming out of, making his life a misery.

The long gap made the operation to fix the problem in his back much more difficult than if it had been carried out sooner, but fortunately for the former builder he was under the care of world class specialists.

“The issue is that throughout the operation one lung has to be on a ventilator or he has to be on a machine to support his hearts and lungs,” said Mr Coonar.

“Many anaesthetics won’t touch a patient who has had his lung removed, but in our hospital that’s their bread and butter.

“Not only did they have to do that, but for an extended period of time. Kevin was very stable throughout and had no side effects.”

But despite the anaesthetic working well, the operation itself proved to be extremely difficult, as will be shown on the BBC series Surgeons: At the Edge of Life on Tuesday.

For a start, because it was hard to find tissues to fill the space in Kevin’s chest wall it would need a plastic surgeon, with Professor Charles Malata from Addenbrooke’s Hospital brought in to join the team.

“I discussed it with Charles and we decided the only solution was to put in muscle from the other side. We had to attach it, but then detach it then reattach it again,” said Mr Coonar.

“We had to do the operation in a phased way. We started by doing things on the right side then moved to the left side so he had to be turned.

“We started off by cutting open the right side of the chest wall to clean out the filth and make a bed for the muscle to lie in.

“We had to cut off a lot of scar tissue which was like concrete. Millimetres away is the heart so I had to be very careful. At some stages I thought it would be too hard, too dangerous, but I kept going.

“This took me three to four hours to do.”

Kevin was then turned over so Mr Malata could take out a large piece of muscle from his left side then transfer it over quickly into the chest gap on his right.

“He was joining up small vessels using finer sutures then they use in heart surgery. Initially it was good, but not long after the muscle flap was looking like it was not as healthy as it should be,” Mr Coonar continued.

“He had to cut it back and re-do it. It took double the time and added two to three hours to the surgery.

“After that Kevin had good blood flow and drainage so the muscle flap was in good condition. Then we were able to put it in place and begin the process of closing up the wound.”

However, the complication with joining up the small vessels turned out not to be the only issue.

I was really concerned I literally would not be able to cut through the chest wall,” Mr Coonar said.

“The instruments would not cut through it so I had to use electric saws.”

The procedure, which is the longest Mr Coonar has ever been involved in, finally finished at 4am and was only successful thanks to a superb team effort - there were about 25 people from both hospitals involved in Kevin’s surgery.

“There were two main anaesthetics who took over from each other,” the 55-year-old said.

“We could not have done it without them or others who were involved.

“When you do long operations you have to take breaks. We’re still there, but sometimes as moral support.

“We are always checking on each other. At 11pm I ordered a big takeaway. I’m not sure how many people ate it but it’s about morale.

“I’ve built up a lot of stamina over the years. The longest I’ve been up without sleep is three consecutive days and nights when I did consecutive lung transplants.”

The cameras were rolling during the entire operation at Royal Papworth, which is the UK’s leading heart and lung hospital, although it does not cover the extensive preparation work which goes on beforehand. Or even the many years of sacrifice which Mr Coonar and his fellow medical professionals have made which has meant missing out on a lot of family time.

“From my point of view we need to tell people about the NHS and our work,” added Mr Coonar.

“When you go to other countries you really see how good the NHS is. It has problems, but overall the standard is so high.

“Kevin has taken charge of his own healthcare. It’s so important to do that and people should not be passive about their healthcare.

“If people don’t get appointments from doctors, chase them up. Things go off the radar, so if people are proactive it really helps the system.”

Surgeons: At the Edge of Life, continues on Tuesday, October 13 at 9pm on BBC Two.