We did our best to save the Ven. Bellanwila prelate, says doctor
As the nation bid farewell to one of the country's erudite prelates the Ven. Prof. Bellanwila Wimalaratana Thera, questions over the death of the scholarly monk are clarified by the team of doctors who attended on him and fought hard to save his life. Dr. D. M. Sumana Handagala, Thoracic Surgeon of the National Hospital for Respiratory Disease, Welisara rushed to the Kalubowila Teaching Hospital on Feb 2 to treat the injured priest as he was the on- call Consultant Surgeon. Dr. Handagala told the Sunday Times that after an initial assessment he had found that the prelate had suffered severe blunt trauma to the chest with lung tears (laceration) and significant flail segment (free moving chest wall segment due to dual fractures in 5 ribs).
“The priest told me he had a fall, but did not mention an attack by a tusker. However, I believe given the nature of the rib injuries that they were not from a mere fall, but would have involved severe force. Out of the 24 ribs, 16 were damaged,” he said. The staff of Kalubowila Hospital had administered the appropriate initial treatment, which included inserting a tube into the right chest, administering high flow of oxygen and appropriate pain killers. The Cardiologist who performed the echocardiograph said he had no objections if the monk needed to be transfered and felt clinically the monk's heart could withstand chest surgery, Dr. Handagala said.
“I discussed the clinical situation of the patient with my colleague Dr. Sujeewa Ilangamage, a Consultant Thoracic surgeon, and my consultant Anaesthetist Dr. K.A.P. Dhammika, and came to the conclusion that the best treatment for the monk at that stage was an operation, repair the lung injuries and fix the most unstable fractured ribs,” he said. Dr. Handagala said he opined that the surgery could be performed at the Kalubowila Hospital, although the facilities there were limitted and the patient would require great care. “After discussion, the dayakas of the Bellanwila Temple suggested that the operation be performed at a leading private hospital in Colombo. I mentioned that no professional fee would be charged,” Dr. Handagala said. According to him, the most appropriate course of action in the treatment of rib fractures with a flail segment was an early fixation of unstable ribs after repairing any internal injury. In his opinion, non- invasive management by means of connecting the patient to a ventilator with high pressure was not an answer as the existing lung tear would result in air leak, leading to inadequate oxygen for the patient.
“What we thought best was a damage-control strategy but not a total correction of all injuries. We did not fix some of the stable fractures on the right side and did not touch the six left rib fractures at all.” The chest surgery took 7 hours, where only severely damaged ribs were corrected with 57 specialised titanium screws and plates, the doctor said. According to him, the Ven. Thera, who had suffered a fracture to the right upper limb bone, had requested the Consultant Orthopedic Surgeon Dr. Chandana Karunathilake to mend the limb as it was extremely painful. “Since the patient's general condition was stable throughout the chest operation my anesthetist did not object to the limb operation being done immedi- ately after ours so that the viability of the limb could be protected. It was unfortunate that the priest succumbed to a myocardial infarction (heart attack) 2 hours after the operation, despite our best attempts. This could have been contributed to by the monk's diabetes mellitus, high blood pres- sure, age, stress factors due to injury, the surgery and prolonged anaesthesia,” Dr. Handagala said.
According to him, the team of doctors including the Thoracic, Orthopaedic and General Surgeons ( Dr. Amila Jayasekera, Dr. Aathawan), General P hy s i c i a n s , Cardiologists, Dr. Priyankara Jayawardena, Dr. Vajira Senaratne, Dr. Taniya Perera, Dr. Stanley Amarasekera and Consultant Cardio Surgeon Dr. Lahie had all fought long and hard to try and save the monk's life without charging any professional fee.