Emergency Free Flap Surgery is a unique Microvascular surgery which is done by plastic surgeons in order to provide the best possible functionality of a new tongue.

A 30-year-old male patient had visited Narayana Superspeciality Hospital, Howrah in January for an ulcer over left side of his tongue (noted since October 2018) which had been already biopsied and diagnosed to be tongue cancer.
He had been a regular gutka chewer, smoker and pan consumer. He also had history of a surgery for cancer over right side of mouth 2 years back (which is now healed).

On February 7 early morning he started having torrential bleeding from the tongue ulcer. Approximately one liter had bled out by the time he reached hospital at 1000 hours. He was admitted and immediately OT was arranged and a team of Oncosurgeons under Dr. Sourav Datta, Dr.Harsh Dhar, Dr. Apurva Garg) and Plastic Surgeon Dr. Adhish Basu got to work. As a team removed the tongue cancerous growth, a team of plastic surgeons rapidly harvested tissue from the thigh with its blood supply and transplanted it to the mouth, to recreate the patient’s tongue.

Within 6 hours the surgery and rebuilding the tongue was completed and patient is making an uneventful recovery. There was high risk of Aspiration of blood and death when such massive bleeding develops inside the mouth. As patient becomes unconscious due to rapid blood loss and then drowns in his own blood.
 

Dr. Adhish Basu, Plastic Surgeon NSH, Howrah today said, “We had to conduct an emergency free-flap surgery to save the patient's life. The entire tumour was removed and we reconstructed his tongue.” That Dr. Harsh Dhar Consultant - Head & Neck Onco Surgery, NSH Howrah, added,“We perform such surgeries regularly, but they are all planned. That it was done as an emergency makes it stand out.”

This patient had been refused surgery at other hospitals and hence he would have died unless this surgery was performed. This emergency microvascular surgery was attempted in NSH Hospital Howrah, where 100 such routine microvascular surgeries are performed per year. Microvascular surgery = suturing of 1 mm sized artery and veins under microscope.