Surgery staff modify equipment, repair lung

Aviano Air Base, Italy -- The drive to get the job done is what the Air Force is all about and the 31st Medical Operations Squadron is no exception. 

Staff Sgt. Anthony Lenczowski, 603rd Air Control Squadron electrical power production craftsman, went to the Aviano military treatment facility in January for a check-up appointment after being released from the Pordenone hospital, where he was treated for injuries sustained during a motorcycle accident. 

There, the surgery staff discovered that despite his release, Sergeant Lenczowski was still injured. 

"We took X-rays that showed us he had Hemopneumothorax - blood and air collected between the lung and chest wall," said Maj. (Dr.) Hope Hammett, 31st MDOS general surgeon. "The disease can have pretty bad consequences down the road if left untreated." 

In order to remove the blood and air from Sergeant Lenczowski's lungs, the surgery staff needed to perform a procedure known as video-assisted thoracoscopic surgery. The procedure uses a small video camera that allows a surgeon to see inside a patient's chest and operate without having to open the entire chest cavity. 

The procedure was developed to help reduce post-surgery pain and risk of infection associated with opening up the rib cage. 

"[Sergeant Lenczowski] looks great, he's active and the pain has been minimal, which is the big advantage to a procedure like this," said Major Hammett. "You can't even compare the recovery time to the old method. Normally, it's so painful that patients were kept in the hospital for a long time just to help manage the pain." 

While the procedure itself is straightforward, for Major Hammett and the surgical staff, there were several challenges to getting Sergeant Lenczowski well again. 

"The case itself is almost elegantly simple in technique. However, the set-up and coordination to successfully accomplish a case like this at a small facility like the 31st Medical Group is quite an extraordinary achievement," said Maj. (Dr.) Rachel Hight, 31st MDOS chief of general surgery. "If not for Dr. Hammett and all the support staff who contributed, this patient would have needed to go to an Italian hospital or all the way to Germany." 

In order to prepare for the operation, the surgical staff had to modify several pieces of equipment normally used for video-assisted surgery in the abdomen. 

"The role of the anesthetists' team was vital," said Major Hammett. "The procedure is done with only putting air into the lung you're working on, so we had to modify some equipment and used what we had on hand. The anesthetists did a phenomenal job coming together to make this procedure happen." 

In addition to the punctured lung that caused the blood to collect in his chest, Sergeant Lenczowski also sustained a broken foot and right hand that needed three steel pins to repair, a fractured wrist, broken rib, a concussion, a separated clavicle and severe bruising on his legs and back. 

In the three weeks since the procedure, Sergeant Lenczowski's injuries have improved, and he is expected to make a full recovery. 

"Everything but my arms feels better," he said. "Besides my arm and wrist, I feel fine until I sneeze - then my chest and back hurt. But I feel a lot better each day. 

"Dr. Hammett, in my and my wife's eyes, went way above and beyond," said Sergeant Lenczowski. "She personally went through the equipment and made sure they were able to get all the instruments and equipment they needed to successfully complete the surgery."