Salford Royal hospital has pioneered keyhole surgery with a patient who was awake throughout the whole procedure.
Oliver Moody, 26, from Leeds, was the first patient in the country to benefit from the operation last month.
As a child, Mr Moody was diagnosed with Mucopolysaccharidosis (MPS). The condition means he is missing an important enzyme that breaks down harmful chemicals in parts of his body that causes damage. It has been said that people with MPS usually have severe problems with their bones and most stop growing before their teens.
Over the years, he had several different operations to help him with all the problems created by his condition, including cervical spine decompression and surgery on his eyes, limbs, and hips. The surgery to fix Oliver’s spine was performed using a local anaesthetic, meaning he was numbed at the site of his operation and was awake during the surgery.
Salford Royal leading the way with a national first, and possibly a world first, surgical procedure. https://t.co/7IS8wXAz6s
— Salford Care Organisation (@SalfordRoyalNHS) November 30, 2021
He said: “I was nervous, but this was more about what the operation meant to me, rather than the operation itself. It was ‘make or break’ for me because I knew I couldn’t go on with the way things were. I had painful cramping in my legs every couple of minutes pretty much 24/7.”
Due to his condition, one of the bones in his spine had not formed properly which caused one of his spinal discs to bulge. In 2017 he started experiencing pain in his legs and the pressure of the discs on his spinal nerves was starting to create problems.
He was referred to Salford Royal, part of the Northern Care Alliance NHS Foundation Trust, which, via the Greater Manchester Centre for Clinical Neurosciences, offers world-class care for people with brain and spine disorders and injuries from across the UK.
“If we did nothing, it was only going to get worse, I probably would’ve ended up paralysed. It was a no-brainer for me, I needed to have the operation,” he said.
Specialist in spinal disorders and offering the latest surgical and non-surgical treatment for spinal problems, neurosurgeon Ankur Saxena, could tell from scans that the impact on Oliver’s spine was worsening and the nerves required decompressing.
Mr Saxena believed undertaking the surgery using the key-hole technique and using local anaesthetic would be the best solution for Oliver even though this had never been done before.
Keyhole surgery is a minimally invasive surgery and sees surgeons using an instrument called an endoscope. This is a small tube with a light source and a camera, which relays images of the inside of the body onto a screen to help guide the surgeon’s movements.
Surgery was the only option for doing this but operating on MPS patients is incredibly challenging. Many MPS patients have poor lung capacity, and their trachea (windpipe) is not straight. This means preparing an MPS patient for general anaesthetic, where they are put to sleep and their breathing assisted with a breathing tube through their mouth and throat, is incredibly risky.
Mr Saxena spent many months planning with surgical and anaesthesia colleagues making arrangements for the preferred keyhole surgery to take place under local anaesthetic but also planning the alternative of surgery under general anaesthetic if keyhole couldn’t be done.
Mr Moody said: “I was awake the whole time, talking and listening to music. There were times when I felt a bit of discomfort or a sensation but the levels of painkilling medication were then increased and it passed.”
After the surgery in late October, Mr Saxena admitted that the success of the operation had left him with a “big smile” on his face.
Mr Moody explained: “When the surgery was over, lots of staff members came to see me and said I had done well. I knew it was a big operation and certainly realised that afterwards with the number of people who were interested in how it had gone.”
Since the operation, his standing, walking and balance has improved. He seems to be in less pain.
He said: “It’s never going to be perfect and I won’t be running a marathon any time soon but I am so glad I had the operation and with physiotherapy over a longer period of time, I’m hoping to see much more improvement.
“I know I face further operations in the future but what I want is to be as self-sufficient as possible. I want to be able to drive and so I hope to be able to start doing that in the next six months.”