415 21-11-2012 Cecil Mosupye a patient at George Mokhari hospital in Ga-Rankua is the first CANSA patient to be performed laparoscopic aortobifemoral bypass surgery in south Africa. Picture: TIRO RAMATLHATSE

Johannesburg - A 63-year-old Ga-Rankuwa man became the first patient to undergo a laparoscopic aortobifemural bypass graft in South Africa – but for Cecil Mosupye, the mouthful of an operation was simply an end to months of pain.

Mosupye suffered from blockages in the arteries to his legs, the result of hypertension and years of heavy smoking. In February, he began experiencing pain in his legs when walking.

“It’s a mismatch of supply and demand,” explained Professor Zach Koto, chief of surgery at the University of Limpopo’s Medunsa campus. The muscles needed oxygen, carried by red blood cells, but the constricted arteries could not get enough blood where it was needed.

By the time of his surgery last week, Mosupye was in pain even when resting. His left leg was beginning to change colour.

“If we left the situation as it was, the pain would have worsened. He would have developed gangrene and then he would have needed an amputation,” said Koto.

What Mosupye needed was an aortobifemural bypass graft. The operation involves connecting a Y-shaped artificial artery – or graft – from the body’s main artery to the blood vessels leading to the legs.

“We take the blood from the aorta above the blockage, through the graft, to the arteries below the blockage,” said Koto – literally bypassing the narrowed veins, like an on-ramp leading a car out of traffic and onto a free-flowing highway.

It’s the kind of procedure that’s done on a fairly regular basis, both in South Africa and abroad. But Mosupye’s operation was different.

Usually, the operation involves cutting open the belly area. It’s major surgery that leaves patients in pain, with limited mobility and breathing difficulties while they recover.

“What we did differently this time is that, instead of slashing open the abdomen, we made several small incisions, just big enough to insert a camera the size of a pen called a laparoscope,” said Koto.

In the four-hour-long operation at Dr George Mukhari Hospital in Ga-Rankuwa last Friday, Koto – with surgeons Dr Faisal Ghoor and Dr Peter Kawesa – made six small cuts in Mosupye’s abdomen and a seventh on his bellybutton.

The rolled-up graft was dropped into one of these and connected to the arteries.

“The advantage of laparoscopy is magnification, about 10 times that of the human eye, so we can see much better,” said Koto.

According to the Department of Health, it is, to their knowledge, the first time this procedure has been performed laparoscopically in South Africa.

This form of non-invasive surgery makes recovery both faster and less painful. Already, Mosupye is ready to go home. The pain in his legs stopped immediately – a sign that enough oxygen-carrying blood is now reaching his muscles.

“I’m very proud,” said the pensioner of the first-time op. “And I’m done with smoking.” - The Star