Doctors at HCMCT Manipal Hospital Dwarka have successfully performed a rare simultaneous procedure combining heart bypass surgery and robotic lung cancer surgery on a 66-year-old man diagnosed with both coronary artery disease and lung cancer. The patient, who initially presented with breathlessness during a cancer examination, was found to have severe arterial blockages alongside cancer in the upper lobe of his left lung.
Challenging medical scenario requiring coordinated care
The interconnected nature of the heart and lungs within the chest cavity meant that surgery on one organ could significantly affect the function and recovery of the other. Managing both conditions required careful planning and multidisciplinary collaboration between cardiac and cancer specialists.
Following extensive discussions, the medical team opted for a simultaneous hybrid approach, performing the two procedures sequentially with less than one hour between them. First, surgeons conducted a heart bypass to address the blocked arteries, followed by a lung cancer surgery using the da Vinci surgical system to remove the cancerous portion of the lung.
Robotic precision reduces surgical burden
The da Vinci surgical system provided enhanced 3D visualization and precision during the lung cancer procedure, helping to minimize the overall surgical burden on a patient with significant cardiac risk. Angioplasty was ruled out because it would require prolonged blood-thinning medication, which could have delayed cancer treatment.
Dr. Yugal Kishore Mishra, Chairman of the Manipal Institute of Cardiac Sciences at HCMCT Manipal Hospital Dwarka, stated, "What made this case particularly challenging was that both conditions required urgent intervention. The coronary artery disease significantly increased the risk of cancer surgery, while delaying cancer treatment was not an ideal option either. After careful evaluation, our teams decided on a simultaneous approach that would allow us to address both problems safely in a single sitting."
Expert quotes on the innovative approach
Dr. Surender Kumar Dabas, Chairman of the Manipal Comprehensive Cancer Centre and Onco Robotic Surgeries for the Northwest Cluster, commented, "A cancer diagnosis is always overwhelming on its own, and the challenge becomes even greater when another serious condition requires urgent treatment. Since the patient was to undergo major cardiac surgery, we wanted to minimize the surgical trauma in the subsequent procedure while ensuring complete cancer removal. The da Vinci surgical system enabled us to operate with exceptional precision through a minimally invasive approach, helping reduce recovery time, minimize complications, and support a faster return to normal life."
Dr. Vikas Thakran, Consultant in Cardiology at HCMCT Manipal Hospital Dwarka, added, "The challenge was determining the safest sequence and timing of treatment. Every option carried its own risks and our objective was to ensure that neither condition was compromised while treating the other. In this case, the simultaneous approach allowed us to address both life-threatening conditions during a single session while ensuring patient safety remained our foremost priority."
Recovery and hospital expertise
Despite the complexity of treating two major conditions simultaneously, the patient made a good recovery through careful post-operative care and rehabilitation. He was discharged in a stable condition. This case highlights HCMCT Manipal Hospital Dwarka's expertise in managing highly complex and high-risk conditions through coordinated multidisciplinary care, advanced surgical techniques, and personalized treatment planning.
Manipal Hospitals, a pioneer in healthcare in India, serves over 8 million patients annually across a network of 49 hospitals in 24 cities, with more than 12,600 licensed beds, over 11,000 doctors, and a workforce exceeding 34,000 employees. The hospital network is AAHRPP accredited, with most facilities holding NABH, NABL, ER, and Blood Bank accreditations.
