NAT SC Dr. Maher Khalil and Garry-1615699943678
Dr Maher Khalil with Garry Mervin Perine, a schoolteacher Seychelles after his successful surgery in Dubai. Image Credit: Supplied

Dubai: An overseas cancer patient suffering with cancer of the larynx and pharynx got a new lease of life, as skilled Dubai doctors operated on him in a rare surgery lasting over six hours.

The patient, who flew in from Seychelles in October 2020, was able to return home, with most of his vital functions intact.

Six-hour life-saving surgery

The radical life-saving surgery has gone to prove why Dubai is considered one of the most preferred medical tourism destinations of the region. It is surgeries like these that have helped UAE earn the number one rank for medical tourism as per a survey result released by UK’s Global Soft Power Index. Medical tourists were able to come to the UAE, despite the pandemic as the country also has been ranked the 14th best worldwide in managing COVID-19.

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Patient googled for best hospitals and chose Dubai

In this case, Garry Mervin Perine, 50, a schoolteacher and resident of Seychelles, was unable to swallow food or drink for several days, had lost enormous amount of body weight and was severely malnourished. Unable to find a suitable doctor in Seychelles, he began surfing the net for help in the region and stumbled upon the NMC hospital website, which had just the right doctor to diagnose and intervene in his case.

With support from the Seychelles government, Perine was flown to Dubai for consultation with Dr Maher Khalil, Consultant ENT specialising in head and neck surgery, at the NMC Royal Hospital, DIP, Dubai.

Patient malnourished

Dr Maher Khalil

Dr Khalil said: “When the patient first met us, he was just on a liquid diet as he had developed swelling at the right side of the neck. He had suffered a considerable loss of weight and was encountering breathing problems as well.”

A clinical examination, diagnostic Neck CAT scan and lab results all showed that Perine had cancer in the larynx, the voice box, with infiltration to the pharynx, the passage of food and air in the neck area. Dr Khalil reiterated that Perine’s cancerous tumour was in advanced stages with a spread to the lymph nodes, our body’s defence system against infection and diseases. “Since the patient had become weak with extreme malnutrition, we asked Melissa Mathias, our chief clinical dietitian, help him gain strength to bear the planned long haul surgery of two stages,” said Dr. Khalil. After two weeks of detailed preparations and planning, the patient was wheeled into the operation theatre.

Larynx removed, pharynx reconstructed

Elaborating on the actual surgery, Dr Khalil said, “We performed an advanced cancer surgery, that involved the complete removal of the larynx (voice box) as well as a portion of the swallowing pipe or the pharynx (partial pharyngectomy) and a radical lymph nodes bilateral neck dissection.” The surgeons made sure that the post-surgery report showed complete obliteration of the cancerous tumour.

Forearm skin used to reconstruct food pipe

Dr Vikas Verma

One the excision was carried out, Dr Vikas Verma, Consultant Plastic Surgeon, worked on reconstructing Perine’s pharynx by taking the skin from the patient’s forearm alongside their blood vessels. “The key objective of any surgery is try to restore the functionality of the human body and its organs so that the patient can live a healthy and a normal life,” said Dr Verma. Dr Khalil then worked on fixing the connections appropriately.

Post-surgery, Perine remained in the intensive care unit for observation. After four weeks of intensive care admission and multiple physiotherapy sessions, he responded well. At the follow up after four months, Garry started again to eat and drink normally.

Learning to speak without a voice-box

Once the swallowing mechanism was restored, the challenge was to get the patient to speak without the larynx. The patient was provided intensive oesophagal speech therapy. This therapy involves training the patient to move air down the food pipe. When the air passes through the muscles of the throat, it makes vibrations. The patient was trained to use these vibrations and turn them into speech by moving the mouth lips, explained Dr Khalil.

Perine grateful to be alive

Despite some deficits, Perine was thankful to be cancer-free and was able to resume most of his daily activities and wrote a sincere note of gratitude to his doctors. He is expected to continue his radiotherapy and chemotherapy sessions to be able to stay cancer-free.

Top-level health care in UAE

Michael Brenden Davis, CEO of NMC Healthcare said, “Dubai is one of the top global trade and travel destinations in the world, and the work that has been done to strengthen our health care practice should continue to aid the emirate in becoming a global health tourism destination.”