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Former milkman has entire lung removed through keyhole surgery in world first for Royal Papworth Hospital in Cambridge




A former milkman treated at the Royal Papworth Hospital admitted he was “a touch apprehensive” when told he was to be the first patient in the world to have an entire lung removed using keyhole surgery, thanks to a pioneering technique.

Raymond Page, 74, has been suffering with stage 3 lung cancer - an advanced form - and required a pneumonectomy.

Royal Papworth Hospital patient Raymond Page with consultant thoracic surgeon Giuseppe Aresu after the world-first operation to remove a entire lung using keyhole surgery (27817393)
Royal Papworth Hospital patient Raymond Page with consultant thoracic surgeon Giuseppe Aresu after the world-first operation to remove a entire lung using keyhole surgery (27817393)

In a three-hour operation performed in November 2019, surgical teams removed his whole lung after making a cut between the abdominal muscles, called the subxiphoid, of just five centimetres.

Raymond was under general anaesthetic, but the anaesthetic team controlled the pain using a ‘non-intubated’ method, meaning there were no tubes involved.

Instead, he was kept breathing spontaneously on a gaseous mixture of oxygen, air and sevoflurane, free of opioids.

Raymond, who said it was “special” to be involved in a world first procedure, got out of bed within hours and was walking free of pain within a couple of days - going back to his Peterborough home after six days, instead of the 10 he expected.

“I must admit that I was a touch apprehensive when I was initially being told about the technique and the possibility of being the first patient, but the team were brilliant at laying out all the options and I was happy to go ahead,” he said. “They have done a marvellous job and I cannot thank everyone at Royal Papworth enough.

“I had the occasional bit of pain when coughing for the first day but that’s it really – I could walk and move about fine even just a couple of days afterwards which I really was not expecting.

The team at Royal Papworth Hospital with patient Ray Page after the world's first keyhole surgery to remove an entire lung (27817382)
The team at Royal Papworth Hospital with patient Ray Page after the world's first keyhole surgery to remove an entire lung (27817382)

“I was thinking that it might take up to 10 days to recover but I went home after six days and there was no pain whatsoever. I’m sure my wife of almost 51 years, Jo, and all my grandchildren will keep me on my toes as I continue my rehabilitation.”

The goal of performing thoracic operations in this way is to reduce the risk of respiratory complications and improve recovery times, compared to traditional procedures, in which a patient’s chest is opened up under general anaesthetic.

Consultant thoracic surgeon Giuseppe Aresu said: “This patient had two tumours in his right lung - one across two lobes plus another tumour at the level of the upper lobe. Our only option to achieve a complete resection of the malignancy was to perform a pneumonectomy.

“Doing the operation using a subxiphoid approach – which involves a small incision under the ribcage and therefore completely avoiding the intercostal nerves - has the potential benefit of reducing the surgical impact, post-operative pain.

“We also used a non-intubated, opioid-free anaesthetic technique which further reduces the impact on the patient, making the recovery quicker and safer.”

And he told the Cambridge Independent: “The initial cut was one inch (2.5cm) and we had to enlarge it just to remove the lung and the big tumour.”

Georgina Howell is one of nine thoracic oncology specialist nurses who look after lung cancer patients at Royal Papworth from initial investigation work through to discharge and settling in back at home.

Exterior of Royal Papworth Hospital celebrating their 'Outstanding' status. Picture: Keith Heppell. (27818771)
Exterior of Royal Papworth Hospital celebrating their 'Outstanding' status. Picture: Keith Heppell. (27818771)

She said: “I saw Mr Page at his pre-op clinic and also went to see him in critical care after surgery and he looked amazing considering the short space of time since his operation.

“We provide a telephone link-line call to all patients once they have been discharged home to see how they are recovering and provide any advice if necessary. On the second call, just a fortnight after his operation, he was sounding remarkably well.

“It’s always rewarding for us as a team to know that we have played our part in helping our patients on the road to a full recovery.”

The Royal Papworth Hospital, which moved from Papworth to its new site on Cambridge Biomedical Campus in April 2019, is no stranger to world firsts.

In 1979, the UK’s first successful heart transplant was carried out at Papworth.

In 1984, Papworth surgeons performed Europe’s first successful heart-lung transplant.

Two years later, the world’s first successful heart-lung and liver transplant was performed at Papworth.

And in 2015, Europe’s first non-beating (DCD) heart transplant was carried out at the hospital.

In 2018-19, it carried out more heart and lung transplants than any other hospital.

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