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BBC – Surgeons: At the Edge of Life (2018) Episode 3

BBC Surgeons At the Edge of Life 3of3

Most people will have an operation in their lifetime, but few of us have a clue what really happens once we are put to sleep. This series goes beyond the theatre doors of the surgical unit at the Queen Elizabeth Hospital Birmingham, where 700 operations are carried out every week, across 42 specialist theatres. Whilst many operations are vital but routine, this series focuses on some of the country’s top surgeons as they perform high-stakes surgery that simply wouldn’t have been attempted a few years ago, pushing the boundaries of modern medicine to its very limits. Unprecedented opportunities to save lives offer surgeons the chance to develop their astonishing skills – but also carry daunting risks and responsibilities. A dark sense of humour, a cool head and extraordinary levels of accomplishment are the tools of the trade.

Part 1: The Longest Day
Specialist maxillofacial surgeons Tim Martin and Sat Parmar prepare for a marathon operation on 53-year-old Teresa. Four weeks ago, Teresa was diagnosed with a fast-growing cancerous tumour in her face and she will die within weeks unless it is removed. The procedure involves radical surgery to the entire right-hand side of her face, and means she will lose both her upper jaw and right eye. It is an enormous undertaking for Teresa, and for Tim and Sat, too.

Using 3D imaging, the team plan how to remove the tumour and, most importantly, how they will rebuild Teresa’s face. Tim and Sat are all too aware that whilst removing the tumour will save her life, it will be devastating if she is left disfigured and unable to face the world. To give her the best possible outcome, they intend to fill the cavity left in Teresa’s face with a section of bone and muscle removed from her hip, using a 3D-printed plastic guide that helps them cut out the correct shape bone.


Part 2: Last Chance Saloon
Two procedures so formidable, they would not have been attempted even a few years ago. Surgical teams at the Queen Elizabeth are constantly pushing the limits of what is possible. But despite state-of-the-art diagnostic scanning, sometimes cancer surgeons don’t know exactly what they are up against until they open the patient up on the operating table. Even with the most meticulous planning, sometimes they must resort to taking critical decisions live in the theatre.

74-year-old Jasmine Harkness has been referred to the specialist sarcoma unit with a vast tumour in her abdomen, weighing more than three stone – a third of her total body weight. It is consuming her, displacing organs including her stomach and liver. Unless it can be removed, she has just four weeks to live. Sarcoma specialists Sam Ford and Professor David Gourevitch can’t be sure whether they will be able to save Jasmine until they open her up and inspect her anatomy. Such is the risk of this surgery – five years ago they would not have embarked on this intervention.

Sue Sinclair, lead anaesthetist and matriarch of theatre, keeps the others in check – working alongside them as they battle to detach the tumour from Jasmine’s organs and blood vessels, and remove it intact. Whenever it presses heavily on vital blood vessels, Jasmine’s blood pressure plummets, placing her life in grave danger. It will take unwavering focus to keep her alive. The tumour has grown so invasively that it has crushed and displaced Jasmine’s internal organs. Sam and David have a puzzle on their hands to identify what and where everything is. At times, dark humour is the only way to release the tension as they grapple with blood, guts and mind-boggling complexity.


Part 3: The Pioneers
Many clinical trials target the nation’s most acute health issues. With deaths from liver disease soaring by 40 per cent in a decade, more and more patients are waiting for vital liver transplants. There is a shortage of organ donors and many donated organs are rejected as only those in excellent condition are considered suitable for a transplant procedure. Surgeons Richard Laing and Thamara Perera are part of a team at QEHB trialling a revolutionary way to tackle this crisis, by maximising the number of donor organs that can be safely re-used.

The film follows the trial every step of the way, as Richard receives a donor liver that would usually be rejected and tries to prove it is viable for transplant by rejuvenating and testing it on a perfusion machine. This machine sustains the liver by mimicking the supply of blood, oxygen and nutrients an organ receives inside a live, healthy human body. Once the donor liver has proved itself fit for transplant, the surgical team start to remove grandmother Connie O’Driscoll’s severely diseased liver. Once the donor liver has been disconnected from the perfusion machine, they have just 20 minutes to place it in Connie’s body and plumb it into the complex and delicate network of hepatic blood vessels.

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