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Dr. Gupta: Inside the TB patient's surgery

  • Story Highlights
  • Speaker's TB surgery was risky not just for him but for surgical crew as well
  • Speaker's lung tissue didn't look normal; was dark and bumpy instead of smooth
  • Diseased tissued was sealed in bag before it was removed from Speaker's body
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By Dr. Sanjay Gupta
Senior Medical Correspondent
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AURORA, Colorado (CNN) -- Before the surgery even began, hospital officials spent a lot of time preparing us for the idea that this operation was not only risky for the patient, but also everyone else in the room.

Dr. Sanjay Gupta says most delicate part of Andrew Speaker's surgery was separating the diseased lung tissue.

Whenever you're operating on someone for infectious disease, there's a real threat that you yourself can get infected -- surgeons, nurses and observers.

As a neurosurgeon who has performed many delicate procedures, that was the biggest difference for me.

We had to wear special air-tight masks. I put a mask on, and then the medical team put my entire head in a hood. They sprayed this bitter stuff into the single hole in the hood to see if I could taste or smell the spray. If I could, that meant the mask wasn't working. Video Watch what happened inside the operating room »

Then, they had me read a page of material without being winded. Because my face and nose were covered, they wanted to make sure I wasn't going to pass out from this very air-tight mask.

Then, the procedure began. You could immediately notice the diseased part of the lung. A healthy lung has a very smooth border. It almost glistens, and it has a reddish look about it.

But Speaker's diseased area had a lot of bumps on it. Other parts of the lung were much darker. It almost looked like some of the cells had died. Then, you could also see pockets of white areas, which were the cavities of tuberculosis infection.

So, you saw those cavities and you saw the very diseased areas all around it. We saw this all through video scope.

During the two-hour procedure, there were three surgeons. You could tell this was a pretty close bunch. They liked rock 'n' roll. You could hear the music throughout the operation. There was a lot of banter back and forth as well -- some serious, some less so.

You just got the sense that this was a team that worked well together.

The most difficult and delicate part of this procedure was actually trying to separate the diseased part of the lung, the right upper lobe, from the blood vessels that provide blood flow and from parts of the airway that were connected.

The surgeons actually had to find those blood vessels that were buried in this diseased tissue. It required a lot of precise inspection to find the vessels and then divide them so the lung could come out. If something goes wrong during that part of the procedure, you can get significant bleeding, which can fill up a patient's chest cavity rather quickly.

Once they had completely separated the diseased area of the lung 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. They literally just picked it up with a pair of forceps, then pulled it out of the body.

The key to that was to keep the diseased area from infecting the chest wall or any other part of Speaker's body. That part only took a few minutes. But the entire procedure leading up that point took a couple of hours.

There were really no problems with the operation. It went just as we were told it would.


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

A lot of testing will take place before the tissue is disposed of. For a long time, doctors have been able to test only Speaker's cough production. Now, they actually have an opportunity to look at the lung and the bacteria itself. E-mail to a friend E-mail to a friend

Senior producer Wayne Drash contributed to this report.

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