The evolution of plastic surgery in Northern Tasmania was highlighted at Launceston General Hospital recently, with an 11 hour procedure involving two surgical teams.
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In order to completely remove skin cancer located on the patient’s lower lip, surgeons Robert Boyle and Michael Thomson also needed to remove nearly the entire lower jaw bone.
After successfully harvesting bone from the patient’s leg, the surgeons were able to reconstruct the jaw – complete with a titanium plate.
“It was a fairly common tumour – a skin cancer of the lower lip – but it does tend to spread to other parts of the body,” Mr Boyle explained.
“In this particular instance it had spread to one of the nerves on the chin, which actually gets there by running through the lower jaw – it actually runs through the bone.
“So we planned to get rid of the tumour of the lip, but in doing so we had to get rid of almost half of his lower jaw. My team got rid of the tumour and cut away a lot of the tissue surrounding it, while Dr Thomson harvested bone from the leg.
“Together we attached it to the gap between one part of the lower jaw and the other, anchored by titanium plate.”
Known as a free flap procedure, Mr Boyle said the bone needed to be taken from the leg complete with tissue and its own blood supply in order to keep it alive.
“Without that it would have just been a graft relying on local conditions to take and those aren’t usually successful,” he said.
“The bone was then micro-surgically attached to other arteries and veins in the neck area.”
The major reconstruction was similar to one Mr Boyle performed more than 38 years ago at the Royal Hobart Hospital – the first of its kind for Tasmania.
While not an uncommon procedure at many major hospitals, Mr Boyle said the success at the LGH symbolised just how far reconstructive surgery in the state’s North had come.
“It is a large, multidisciplinary attack which a lot of people in Tasmania are not aware is available here, but it is,” he said.
“It was a great effort by all involved and I would say it went better than we could have ever planned.
“There’s new ideas coming in all the time with some of the newer plastic surgeons that have been appointed to the hospital. It is really evolving there.”