In a rare and complex medical achievement, doctors at HCMCT Manipal Hospital Dwarka successfully performed a life-saving hybrid procedure on a 66-year-old man who was battling two serious health conditions simultaneously — severe coronary artery disease and lung cancer.

The patient was undergoing evaluation for lung cancer when he complained of persistent breathlessness. Further investigations revealed critical blockages in his heart arteries along with cancer in the upper lobe of his left lung. Treating both conditions at the same time was a major challenge, as the heart and lungs work closely together, and surgery on one organ could significantly affect the functioning and recovery of the other.

After detailed discussions involving specialists from cardiac sciences and cancer care teams, doctors decided on a carefully planned simultaneous hybrid approach. The patient underwent heart bypass surgery first to restore blood flow to the heart, followed by robotic-assisted lung cancer surgery within less than an hour to remove the cancer-affected portion of the lung.

Doctors opted against angioplasty because it would have required prolonged blood-thinning medication, which could have delayed the urgently needed cancer surgery. Instead, the combined surgical approach allowed both life-threatening conditions to be addressed without compromising the treatment of either disease.

During the lung cancer procedure, surgeons used the da Vinci Surgical System, which provided enhanced three-dimensional visualisation and improved surgical precision. The minimally invasive robotic technique helped reduce surgical trauma, lower the risk of complications, and support faster recovery in a patient already facing significant cardiac risks.

Speaking about the complexity of the case, Dr. Yugal Kishore Mishra said, “What made this case particularly challenging was that both conditions required urgent intervention. The coronary artery disease significantly increased the risk of cancer surgery, while delaying cancer treatment was not an ideal option either. After careful evaluation, our teams decided on a simultaneous approach that would allow us to address both problems safely in a single sitting.”

He added that such complex cases require meticulous planning, close coordination between multiple specialties, and treatment decisions focused on the patient’s overall well-being.

Highlighting the role of advanced robotic technology in cancer surgery, Dr. Surender Kumar Dabas said, “Since the patient was to undergo major cardiac surgery, our aim was to minimise surgical trauma during the subsequent cancer procedure while ensuring complete removal of the tumour. The da Vinci surgical system enabled us to operate with exceptional precision through a minimally invasive approach, helping reduce recovery time and complications.”

Dr. Vikas Thakran explained that deciding the safest sequence and timing of treatment was the biggest challenge. “Every option carried its own risks, and our priority was to ensure that neither condition was compromised while treating the other. The simultaneous approach allowed us to manage both life-threatening conditions during a single session while keeping patient safety at the centre,” he said.

Following the procedures, the patient received close post-operative monitoring and rehabilitation support. He recovered well and was discharged in a stable condition.

The successful outcome highlights the importance of multidisciplinary teamwork, advanced surgical technology, and personalised treatment strategies in managing patients with multiple complex diseases. 

The case demonstrates how coordinated care can help overcome difficult medical challenges and provide better outcomes for high-risk patients.