Index Super Speciality Hospital, Indore, successfully performed an 11-hour complex cancer surgery on a 40–42-year-old patient, Devendra Ahirewar, suffering from recurrent squamous cell carcinoma in the occipital region of the scalp. The cancer had returned twice after previous surgeries and had progressed to involve and destroy part of the skull bone. The case was further complicated by the patient’s severely reduced cardiac function, with an LVEF of around 25%. A multidisciplinary team of neurosurgery, surgical oncology, reconstructive surgery, anaesthesia and critical care specialists planned and performed the procedure. The objective was to completely remove the recurrent tumour while simultaneously reconstructing the affected skull and the extensive soft-tissue defect.

Under the leadership of Neurosurgeon Dr. Kshitiz Apurva Nigam, the tumour was removed through cranial resection along with the cancer-involved portion of the occipital bone. The skull was subsequently reconstructed using a titanium mesh cranioplasty to restore its structure. Dr. Tanishk Agrawal, Dr. Sparsh Kumar, Dr. Ritik Tripathi and Dr. Yash Dixit assisted in the neurosurgical procedure. Surgical Oncologist Dr. Amay Bhiyani led the reconstructive procedure, using a Latissimus Dorsi (LD) muscle flap harvested from the patient’s back to cover the large soft-tissue defect at the back of the head. Dr. Shubhangi Kanglu assisted in the reconstructive surgery. Considering the patient’s cardiac condition and use of clopidogrel, detailed preoperative evaluation and optimisation were undertaken. Anaesthesia and Critical Care Specialist Dr. Mehul Srivastava led the anaesthesia team, with Dr. Ashutosh and Dr. Digvijay assisting. During the approximately 11-hour procedure, the patient’s cardiac status and other vital parameters were continuously monitored.

The surgery was completed successfully in a single operative stage, achieving tumour removal, skull reconstruction and coverage of the extensive soft-tissue defect. Following surgery, the reconstructed flap was closely monitored, with regular dressings and postoperative care. The patient recovered well and was discharged approximately one week after the procedure. A major highlight of the treatment was that the complex surgery was provided free of cost under the Ayushman Bharat scheme, offering significant financial relief to the patient’s family; such treatment in a private hospital could cost approximately ₹7–8 lakh. Chairman of Mayank Welfare Foundation Shri Suresh Singh Bhadoria, Medical Superintendent Dr. Swati Prashant and Medical Director Dr. Pawan Bhambani appreciated the coordinated efforts of all the teams involved in the successful treatment.