Saturday, 20 February 2010

The Mother Of All Surgeries (MOAS)

Tuesday 2nd Feb.....

So it was time, the big day was here. I was awoken at 05:45 and had a quick cool shower ( I had been advised not to make it too hot as this could make me bleed on the operating table!). I got dressed into my gown and was given some tablets to make me relax. I sat in the chair and tried to keep my eyes open. Tracey suggested that I get into bed but I wanted to stay in the chair. Finally the theatre staff came and collected me. I said my goodbyes to Tracey and Mum and then must have been overwhelmed by the drugs as I don't really remember too much.
I do remember going into pre op where the anesthetist said hello and it seemed a number of people started work quickly. I vaguely remember her telling me she was putting in a cannula and that she was giving me some drugs and the that was it. Lights out, good night Irene!

Tracey and mum sat in my room for a bit and composed themselves as they were both upset. My bags were collected by the nursing staff and locked away. Tracey and mum went back to the flat. The first call from the surgical team came in at around 13:30hrs and advised that the extent of the disease was pretty bad and that they had removed my spleen,gall bladder and had re sectioned some of my bowl which would mean a temporary stoma.They also suggested that they were confident that they could get all the tumor.

The second call came in at 17:30hrs.It was Mr. Cecil. He said that all the tumor had been removed and that I was getting the chemo and was doing OK. Once the chemo was done they would then start to stitch me back up and he expected me to be in ICU about 22:00hrs.

The third call came in at 21:30 to say that I was in ICU and that I was doing fine and that they should be able to come see me . Tracey and mum were finally allowed in at 23:30hrs to see me. I was on a ventilator and had lots of tubes and pipes attached to machines-
6 x stomach drains
2 x chest drains
1 x catheter
1 x nasal gastric tube
1 x ventilator
1 x central line (in neck)
1 x epidural
cannula's in wrists.

Tracey and mum stayed for approx 1/2 hr and then left as I was still sedated.

I spent a total of 12hrs on the operating table.

During the operation they performed-
A midline laparotomy excising the umbilicus.
They found desiese on the surface of the liver,some desiese on the antrum of the stomach,on the spleen, both right and left diaphragms, a lot of desiese in the pelvis involving the rectum,some desease on the ceacum and terminal ileum and desease on both paracolic gutters. The good news was that there was no desease on the small bowel.
The right paracolic gutter was stripped.
A right hemicolectomy.
Stripped the left diaphragm and mobilised up the spleen.
A greater omenectomy taking the gastroepiploic vessels off the stomach.
Removed the spleen and omentum.
Stripped the right diaphragm.
A lesser omenectomy.
Stripped the porta-hepatis and did a cholecystectomy transfixing the cystic ducts and cystic artery.
A diathermy liver capsulectomy with high power diathermy.
Stripped the left paracolic gutter.
A pelvic peritonectomy.
An anterior resection as the rectum could not be sepearted from the desease.
Having remouved all the macroscopic desease I was then given 1 hour of heated intra operative Mitomycin C at 41 degC.
An end to side anastomosis of the colon on to the rectum.
A hand sewn 2 layer anastomosis with interrupted 3/0 PDS of ileum on to ceacum.
A right iliac fossa loop ileostomy.


  1. Thanks for the detail. My wife is facing MOAS for metastasized ovarian cancer this month. Our oncologist is very sparce with information.

  2. My sister-in-law just had this procedure. She said it was the 'mother of all surgeries'. I had no idea. I pray for her recovery and for yours as well!

  3. Thank you very much for all information. Our sons awaiting for green light for operation, prolly in the next 2 to 3 weeks in Sydney. Very trying and difficult time for all of us. God bless us all

  4. Thanks for letting us know what is involved, my dad goes for the first surgery in october