Features
Thomian cricketer Sarath Seneviratne’s surgical feat in the Caymans
A team of doctors led by Dr. Sarath de Alwis Seneviratne, Associate Professor/Senior Consultant, at CTMH, The Doctors Hospital in the Cayman Islands, recently removed a giant tumour from the uterus of a patient – the largest seen on the Cayman Islands and perhaps the world. Seneviratne was assisted by surgeons Dr Steve Tomlinson, F.R.C.S., L.R.C.P and Dr Chris Bromley, F.R.C.S. (Eng.), F.R.C.S. (Edin.).
Lankan surgeon removes giant tumour in the Cayman Islands
A team of doctors led by Dr. Sarath Seneviratne (STC CRICKET & SPORTS FAME), Associate Professor/Senior Consultant, at CTMH The Doctors Hospital in the Cayman Islands, recently removed a giant tumour from the uterus of a patient, which was easily one of the largest tumours the doctors had ever removed, weighing in at 21 pounds 2 ounces. This was very likely the largest tumour ever seen by surgeons in the Cayman Islands and one of the largest ever seen in the world with a successful outcome. The team of medical professionals who successfully removed the tumour was led by Dr. Sarath, assisted by surgeons Dr Steve Tomlinson, FRCS, LRCP and Dr Chris Bromley, FRCS. (Eng.) and (Edin).
“The patient was presented with an abdominal mass extending to the chest and extending under the liver. She was in considerable pain and discomfort, particularly in the back, having undergone surgery previously in London “. Dr Sarath Seneviratne said. “She needed the mass to come out.”
It was anticipated that the surgery would take three hours and present challenges, given the size of the mass. Therefore Seneviratne enlisted the assistance of Drs. Tomlinson and Bromley, along with a team of experienced nurses experienced in working together as a surgical team. The approach was to ensure every measure was taken to keep the patient safe, the doctor advised.
“We anticipated difficult surgery and considerable bleeding,” Seneviratne said. “The anesthetist, Dr Stephen Gay, put in an arterial line rather than the usual venous line to help control the bleeding, as many patients have died under similar circumstances through uncontrollable blood loss, renal failure and sometimes other complications such as a coagulopathy or multiple organ failure.”
The mass was under the diaphragm and pressing against the liver, aorta and kidneys and it had gone into the pelvis; so much so that the pelvic structures could not be seen from below. The abdominal wall was enlarged vertically as well as transversely, that it looked like triplets. The lady had hypertension and weighed over 300 pounds, which added to the risks for anesthesia and surgery.
The size of the mass and intra-abdominal adhesions was the biggest difficulty, because the tumour had attached itself to various parts of the patient’s internal organs, including the small bowel, rectum, bladder and pelvic wall, hence increasing the risk of bleeding.
During the surgery, she was bleeding profusely from all sides of the tumour, especially from behind the mass. Hemostatic clamps and large warm packs were used to control the hemorrhage, while meticulously ligating the vessels.
“We had to stick to basic principles of surgery, we couldn’t do any fancy stuff,” Seneviratne said. “The basic principles are: a) you have to stop the bleeding and b) approach the tumour in such a way that she won’t bleed. Those are the two cardinal things.”
The doctors then had to move quickly to remove the mass, trying to remove it in one piece so it could be examined histologically as a whole, to look for malignancies. They kept the tumour in a large bucket before it was flown to the US to be examined. They managed to save one ovary and the patient went home three days later in good health.
“It was considered one of the biggest tumours in the world, most likely the largest ever in the Cayman Islands,” Seneviratne said.
Assisting surgeon Dr Christopher Bromley said that he had looked at the size of the patient’s stomach with some concern before they began to operate. “I could see it was going to be a substantial operation,” he confirmed.
Bromley said that the operation began smoothly and continued so with Seneviratne performing the surgery “extremely expertly”. However, when they uncovered the tumour he said he was “truly over- awed” at its size.
“It went way beyond my experience, probably the largest I had ever seen,” he said.
“It was the largest uterine fibroid that I had ever seen,” assisting surgeon Dr. Steve Tomlinson confirmed. “The surgery went like clockwork and did not take that long considering the amount of work that had to be done, especially when you consider that a normal hysterectomy takes about an hour. We had a great team – it’s really nice when a team is used to working together and can anticipate whatever the surgeon needs. Everything went very well.”
Seneviratne confirmed this: “You need a very experienced team who are on the ball because we needed 27 needles and sutures, which needed to be constantly given to the surgeon. It’s a synchronised exercise where everybody knows what they are doing. It was a great experience for the team.”
Tomlinson said the patient had told him subsequently that she had lost 32 lbs overall and was doing well now. She has already seen Seneviratne for a check-up and he confirmed she was doing well and had a very positive and cheerful outlook on her situation.
Senior Consultant Obstetrician and Gynaecologist/ Associate Professor Dr Sarath de Alwis-Seneviratne has been practicing medicine in the Caymans for 26 years, having previously practiced in the UK for 14 years. He has delivered thousands of babies and treated thousands of patients in the Cayman Islands over the years, with an unblemished record.
Also of interest is that this ground-breaking doctor has placed the Cayman Islands on the medical map by operating on a patient who was thought to be inoperable by leading cancer specialists in Florida.
Seneviratne explained: “The patient went to her general practitioner with pelvic pain. The GP did an ultrasound scan and found a six cm tumour which the doctor considered to be a possible carcinoma. The GP sent the patient to a consultant OB/GYN Board certified in the USA, who did a CT scan which confirmed the mass. The specialist doctor suspected a malignancy and sent the patient to Baptist Hospital in Florida to one of the best doctors in the world.”
In the USA, the doctors did an MRI and booked the patient in for surgery, but during the surgery, they had a lot of trouble and could not find the tumour because it was not easily accessible. Having spent thousands of dollars up until this point, the patient finally came back to the Caymans with the tumour still inside her.
” We did a scan in my surgery and I identified the tumour to be about six or seven centimeters,” Seneviratne said. “I took her to the operating room and put her under the laparoscope. I do this special technique where I insert a rigid catheter into the bladder and shake the catheter. When the catheter was shaken only the top of the bladder was shaking not the entire bladder, which meant that the tumour was under the bladder. This is an extremely rare presentation and cannot be seen if you just look through a telescope and have a look. I then went under the bladder and removed the tumour, from between the ureters.”
He said that the tumour was bigger than the uterus and the tubes and ovaries put together.
“After two days in the hospital she went home and the biopsy was benign and now she is happy and well,” he confirmed.
Seneviratne is involved in innumerable charities in the Cayman Islands, Sri Lanka and in the Philippines, albeit anonymously. Recently he provided dry rations for the villages around his ancestral home to 750 families.
Dr. Seneviratne’s ualifications include FRCS(Edin), FRCOG(GB), MRCP(Ire), FFSRH(GB), FACOG(USA), MS.(SL), MRCS/LRCP(GB), LRCP/LRCP&S(Edin) and a whole host of other diplomas and memberships. He has a laparoscopic entry method named after him, a suture technique for suturing the vagina and an efficient posture for examination of a prolapsed uterus.
As a fine sportsman here, he captained Sri Lanka cricket President’s Eleven against Malaysia; he headed the national batting, averages in 1976, captained Sri Lanka against Agra at hockey after the New Delhi tournament in India and was awarded the Sports Star trophy at the university. He captained the Colombo and Combined University cricket teams. He captained STC and Combined Schools cricket in 1965. He also represented the Nation in hockey at the Asian Games in Thailand.
Interestingly, he top-scored each time he played against foreign teams. This included the match against State Bank of India, captained by Ajith Wadekar, where the National team was captained by the famous Stanley Jayasinghe. He scored half a century facing up to Venkatarhagavan and V.V.Kumar who were considered to be the best spinners in the world at that time.
He top-scored with half a century, in the Gopalan Trophy match playing for the team captained by Anura Tennakoon; he top-scored against the Australian team captained by Bill Lawry on a wet wicket, in a low scoring match in Kandy.
ESTO PERPETUA
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There’s an ill more dangerous and pervasive than the Coronavirus that’s currently sweeping Sri Lanka. That is the fear to express one’s convictions. Across the public sector of the country in particular many persons holding high office are stringently regulating and controlling the voices of their consciences and this bodes ill for all and the country.
The corrupting impact of fear was discussed in this column a couple of weeks ago when dealing with the military coup in Myanmar. It stands to the enduring credit of ousted Myanmarese Head of Government Aung San Suu Kyi that she, perhaps for the first time in the history of modern political thought, singled out fear, and not power, as the principal cause of corruption within the individual; powerful or otherwise.
To be sure, power corrupts but the corrupting impact of fear is graver and more devastating. For instance, the fear in a person holding ministerial office or in a senior public sector official, that he would lose position and power as a result of speaking out his convictions and sincere beliefs on matters of the first importance, would lead to a country’s ills going unaddressed and uncorrected.
Besides, the individual concerned would be devaluing himself in the eyes of all irrevocably and revealing himself to be a person who would be willing to compromise his moral integrity for petty worldly gain or a ‘mess of pottage’. This happens all the while in Lankan public life. Some of those who have wielded and are wielding immense power in Sri Lanka leave very much to be desired from these standards.
It could be said that fear has prevented Sri Lanka from growing in every vital respect over the decades and has earned for itself the notoriety of being a directionless country.
All these ills and more are contained in the current controversy in Sri Lanka over the disposal of the bodies of Covid victims, for example. The Sri Lankan polity has no choice but to abide by scientific advice on this question. Since authorities of the standing of even the WHO have declared that the burial of the bodies of those dying of Covid could not prove to be injurious to the wider public, the Sri Lankan health authorities could go ahead and sanction the burying of the bodies concerned. What’s preventing the local authorities from taking this course since they claim to be on the side of science? Who or what are they fearing? This is the issue that’s crying out to be probed and answered.
Considering the need for absolute truthfulness and honesty on the part of all relevant persons and quarters in matters such as these, the latter have no choice but to resign from their positions if they are prevented from following the dictates of their consciences. If they are firmly convinced that burials could bring no harm, they are obliged to take up the position that burials should be allowed.
If any ‘higher authority’ is preventing them from allowing burials, our ministers and officials are conscience-bound to renounce their positions in protest, rather than behave compromisingly and engage in ‘double think’ and ‘double talk’. By adopting the latter course they are helping none but keeping the country in a state of chronic uncertainty, which is a handy recipe for social instabiliy and division.
In the Sri Lankan context, the failure on the part of the quarters that matter to follow scientific advice on the burials question could result in the aggravation of Islamophobia, or hatred of the practitioners of Islam, in the country. Sri Lanka could do without this latter phobia and hatred on account of its implications for national stability and development. The 30 year war against separatist forces was all about the prevention by military means of ‘nation-breaking’. The disastrous results for Sri Lanka from this war are continuing to weigh it down and are part of the international offensive against Sri Lanka in the UNHCR.
However, Islamophobia is an almost world wide phenomenon. It was greatly strengthened during Donald Trump’s presidential tenure in the US. While in office Trump resorted to the divisive ruling strategy of quite a few populist authoritarian rulers of the South. Essentially, the manoeuvre is to divide and rule by pandering to the racial prejudices of majority communities.
It has happened continually in Sri Lanka. In the initial post-independence years and for several decades after, it was a case of some populist politicians of the South whipping-up anti-Tamil sentiments. Some Tamil politicians did likewise in respect of the majority community. No doubt, both such quarters have done Sri Lanka immeasurable harm. By failing to follow scientific advice on the burial question and by not doing what is right, Sri Lanka’s current authorities are opening themselves to the charge that they are pandering to religious extremists among the majority community.
The murderous, destructive course of action adopted by some extremist sections among Muslim communities world wide, including of course Sri Lanka, has not earned the condemnation it deserves from moderate Muslims who make-up the preponderant majority in the Muslim community. It is up to moderate opinion in the latter collectivity to come out more strongly and persuasively against religious extremists in their midst. It will prove to have a cementing and unifying impact among communities.
It is not sufficiently appreciated by governments in the global South in particular that by voicing for religious and racial unity and by working consistently towards it, they would be strengthening democratic development, which is an essential condition for a country’s growth in all senses.
A ‘divided house’ is doomed to fall; this is the lesson of history. ‘National security’ cannot be had without human security and peaceful living among communities is central to the latter. There cannot be any ‘double talk’ or ‘politically correct’ opinions on this question. Truth and falsehood are the only valid categories of thought and speech.
Those in authority everywhere claiming to be democratic need to adopt a scientific outlook on this issue as well. Studies conducted on plural societies in South Asia, for example, reveal that the promotion of friendly, cordial ties among communities invariably brings about healing among estranged groups and produces social peace. This is the truth that is waiting to be acted upon.
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By Sanjeewa Jayaweera
It was on 3rd January 1972 that our family arrived in Karachi from Moscow. Our departure from Moscow had been delayed for a few weeks due to the military confrontation between Pakistan and India. It ended on 16th December 1971. After that, international flights were not permitted for some time.
The contrast between Moscow and Karachi was unbelievable. First and foremost, Moscow’s temperature was near minus 40 degrees centigrade, while in Karachi, it was sunny and a warm 28 degrees centigrade. However, what struck us most was the extreme warmth with which the airport authorities greeted our family. As my father was a diplomat, we were quickly ushered to the airport’s VIP Lounge. We were in transit on our way to Rawalpindi, the airport serving the capital of Islamabad.
We quickly realized that the word “we are from Sri Lanka” opened all doors just as saying “open sesame” gained entry to Aladdin’s cave! The broad smile, extreme courtesy, and genuine warmth we received from the Pakistani people were unbelievable.
This was all to do with Mrs Sirima Bandaranaike’s decision to allow Pakistani aircraft to land in Colombo to refuel on the way to Dhaka in East Pakistan during the military confrontation between Pakistan and India. It was a brave decision by Mrs Bandaranaike (Mrs B), and the successive governments and Sri Lanka people are still enjoying the fruits of it. Pakistan has been a steadfast and loyal supporter of our country. They have come to our assistance time and again in times of great need when many have turned their back on us. They have indeed been an “all-weather” friend of our country.
Getting back to 1972, I was an early beneficiary of Pakistani people’s love for Sri Lankans. I failed the entrance exam to gain entry to the only English medium school in Islamabad! However, when I met the Principal, along with my father, he said, “Sanjeewa, although you failed the entrance exam, I will this time make an exception as Sri Lankans are our dear friends.” After that, the joke around the family dinner table was that I owed my education in Pakistan to Mrs B!
At school, my brother and I were extended a warm welcome and always greeted “our good friends from Sri Lanka.” I felt when playing cricket for our college; our runs were cheered more loudly than of others.
One particular incident that I remember well was when the Embassy received a telex from the Foreign inistry. It requested that our High Commissioner seek an immediate meeting with the Prime Minister of Pakistan, Mr Zulifikar Ali Bhutto (ZB), and convey a message from Mrs B. The message requested that an urgent shipment of rice be dispatched to Sri Lanka as there would be an imminent rice shortage. As the Ambassador was not in the station, the responsibility devolved on my father.
It usually takes about a week or more to get an audience with the Prime Minister (PM) of a foreign country due to their busy schedule. However, given the urgency, my father spoke to the Foreign Ministry’s Permanent Sectary, who fortunately was our neighbour and sought an urgent appointment. My father received a call from the PM’s secretary around 10 P.M asking him to come over to the PM’s residence. My father met ZB around midnight. ZB was about to retire to bed and, as such, was in his pyjamas and gown enjoying a cigar! He had greeted my father and had asked, “Mr Jayaweera, what can we do for great friend Madam Bandaranaike?. My father conveyed the message from Colombo and quietly mentioned that there would be riots in the country if there is no rice!
ZB had immediately got the Food Commissioner of Pakistan on the line and said, “I want a shipload of rice to be in Colombo within the next 72 hours!” The Food Commissioner reverted within a few minutes, saying that nothing was available and the last export shipment had left the port only a few hours ago to another country. ZB had instructed to turn the ship around and send it to Colombo. This despite protests from the Food Commissioner about terms and conditions of the Letter of Credit prohibiting non-delivery. Sri Lanka got its delivery of rice!
The next was the visit of Mrs B to Pakistan. On arrival in Rawalpindi airport, she was given a hero’s welcome, which Pakistan had previously only offered to President Gaddafi of Libya, who financially backed Pakistan with his oil money. That day, I missed school and accompanied my parents to the airport. On our way, we witnessed thousands of people had gathered by the roadside to welcome Mrs B.
When we walked to the airport’s tarmac, thousands of people were standing in temporary stands waving Sri Lanka and Pakistan flags and chanting “Sri Lanka Pakistan Zindabad.” The noise emanating from the crowd was as loud and passionate as the cheering that the Pakistani cricket team received during a test match. It was electric!
I believe she was only the second head of state given the privilege of addressing both assemblies of Parliament. The other being Gaddafi. There was genuine affection from Mrs B amongst the people of Pakistan.
I always remember the indefatigable efforts of Mr Abdul Haffez Kardar, a cabinet minister and the President of the Pakistan Cricket Board. From around 1973 onwards, he passionately championed Sri Lanka’s cause to be admitted as a full member of the International Cricket Council (ICC) and granted test status. Every year, he would propose at the ICC’s annual meeting, but England and Australia’s veto kept us out until 1981.
I always felt that our Cricket Board made a mistake by not inviting Pakistan to play our inaugural test match. We should have appreciated Mr Kardar and Pakistan’s efforts. In 1974 the Pakistan board invited our team for a tour involving three test matches and a few first-class games. Most of those who played in our first test match was part of that tour, and no doubt gained significant exposure playing against a highly talented Pakistani team.
Several Pakistani greats were part of the Pakistan and India team that played a match soon after the Central Bank bomb in Colombo to prove that it was safe to play cricket in Colombo. It was a magnificent gesture by both Pakistan and India. Our greatest cricket triumph was in Pakistan when we won the World Cup in 1996. I am sure the players and those who watched the match on TV will remember the passionate support our team received that night from the Pakistani crowd. It was like playing at home!
I also recall reading about how the Pakistani government air freighted several Multi Barrell artillery guns and ammunition to Sri Lanka when the A rmy camp in Jaffna was under severe threat from the LTTE. This was even more important than the shipload of rice that ZB sent. This was crucial as most other countries refused to sell arms to our country during the war.
Time and again, Pakistan has steadfastly supported our country’s cause at the UNHCR. No doubt this year, too, their diplomats will work tirelessly to assist our country.
We extend a warm welcome to Mr Imran Khan, the Prime Minister of Pakistan. He is a truly inspirational individual who was undoubtedly an excellent cricketer. Since retirement from cricket, he has decided to get involved in politics, and after several years of patiently building up his support base, he won the last parliamentary elections. I hope that just as much as he galvanized Sri Lankan cricketers, his political journey would act as a catalyst for people like Kumar Sangakkara and Mahela Jayawardene to get involved in politics. Cricket has been called a “gentleman’s game.” Whilst politics is far from it!.
Author
Believe me, seeing certain videos, on social media, depicting action, on the dance floor, at some of these entertainment venues, got me wondering whether this Coronavirus pandemic is REAL!
To those having a good time, at these particular venues, and, I guess, the management, as well, what the world is experiencing now doesn’t seem to be their concerned.
Obviously, such irresponsible behaviour could create more problems for those who are battling to halt the spread of Covid-19, and the new viriant of Covid, in our part of the world.
The videos, on display, on social media, show certain venues, packed to capacity – with hardly anyone wearing a mask, and social distancing…only a dream..
How can one think of social distancing while gyrating, on a dance floor, that is over crowded!
If this trend continues, it wouldn’t be a surprise if Coronavirus makes its presence felt…at such venues.
And, then, what happens to the entertainment scene, and those involved in this field, especially the musicians? No work, whatsoever!
Lots of countries have closed nightclubs, and venues, where people gather, in order to curtail the spread of this deadly virus that has already claimed the lives of thousands.
Thailand did it and the country is still having lots of restrictions, where entertainment is concerned, and that is probably the reason why Thailand has been able to control the spread of the Coronavirus.
With a population of over 69 million, they have had (so far), a little over 25,000 cases, and 83 deaths, while we, with a population of around 21 million, have over 80,000 cases, and more than 450 deaths.
I’m not saying we should do away with entertainment – totally – but we need to follow a format, connected with the ‘new normal,’ where masks and social distancing are mandatory requirements at these venues. And, dancing, I believe, should be banned, at least temporarily, as one can’t maintain the required social distance, while on the dance floor, especially after drinks.
Police spokesman DIG Ajith Rohana keeps emphasising, on TV, radio, and in the newspapers, the need to adhere to the health regulations, now in force, and that those who fail to do so would be penalised.
He has also stated that plainclothes officers would move around to apprehend such offenders.
Perhaps, he should instruct his officers to pay surprise visits to some of these entertainment venues.
He would certainly have more than a bus load of offenders to be whisked off for PCR/Rapid Antigen tests!
I need to quote what Dr. H.T. Wickremasinghe said in his article, published in The Island of Tuesday, February 16th, 2021:
“…let me conclude, while emphasising the need to continue our general public health measures, such as wearing masks, social distancing, and avoiding crowded gatherings, to reduce the risk of contact with an infected person.
“There is no science to beat common sense.”
But…do some of our folks have this thing called COMMON SENSE!
