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TB Traveler Underwent Surgery to Remove Infected Lung Tissue

Andrew Speaker, 31, the Atlanta lawyer who traveled around with TB infection, underwent surgery to remove the infected lung tissue .

Speaker raised an international health scare when he traveled around with the infection. Tb is a highly contagious disease. Andrew Speaker was diagnosed in May with extensively drug resistant TB, based on an analysis of a sample taken in March by the U.S. Centers for Disease Control and Prevention. The XDR-TB, as it is called, is considered dangerously difficult to treat. He's been under treatment at National Jewish Medical and Research Center in Denver since the end of May.

Speaker underwent a two hour operation at the University of Colorado Hospital to remove the diseased portion of one of his lungs i.e. he upper lobe of his right lung.

The unusual procedure consisted of inserting a video camera in a tube in one small incision in the right side of Speaker's chest, and putting instruments through another incision.

The operation was a highly risky one not only for the patient but for everyone in the room. There was a risk of infecting the surgeons, nurses and observers.

The medical team especially the observers had to wear special air-tight masks and head put in a hood. Special procedures were under taken to check whether the hoods were indeed working.

When the operation began speakers diseased part of the lung was immediately noticeable. It was not a healthy glistening reddish one with smooth border. Speakers diseased part had lots of bumps on it. The lung was much darker. It almost looked like some of the cells had died. There were also pockets of white areas, which were the cavities of tuberculosis infection.

A well coordinated team of three doctors conducted the operation. The most difficult and delicate part of the procedure was actually trying to separate the diseased part of the lung, the right upper lobe, from the blood vessels that pr ovide blood flow and from parts of the airway that were connected.

The surgeons needed a lot of precise inspection to find those blood vessels that were buried in this diseased tissue and then divide them so the lung could come out. Otherwise there could be bleeding which would fill up the cavity.

Once the diseased area of the lung is separated from the body, a bag was placed around it. The bag almost looked like a fishing net, except it was solid all around it with a hoop at the end.

The bag was then cinched shut, with the diseased part of the lung inside and was picked up with a pair of forceps, then pulled it out of the body. The most important part was to keep the diseased area from infecting the chest wall or any other part of Speaker's body. Doctors also wanted to make sure they didn't "release any of those tuberculosis bacteria into the operating room, into the rest of the hospital,"

Speaker will most likely recover at the University of Colorado Hospital for another couple of days, and will return to National Jewish Medical and Research Center in Denver to finish his antibiotic course.

He will still have to continue taking the medications prescribed by his doctors to fight the tuberculosis until cultures taken from him are negative for tuberculosis bacteria for eight weeks.

The diseased part of the lung is now off to microbiology and pathology, where it will be cut up for examination.


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