Awake operation at the Mauriziano hospital
News of
At Turin's Mauriziano Hospital, a 52-year-old man with Charcot-Marie-Tooth disease and bilateral diaphragm paralysis undergoes a laparoscopic cholecystectomy performed while awake, under locoregional anaesthesia and with the support of non-invasive ventilation, thus avoiding the risks of general anaesthesia.[1][2]
The clinical case
The patient has an inherited neurological condition affecting the peripheral nerves, causing progressive muscle weakness and motor difficulties. In his case the disease had also caused bilateral paralysis of the diaphragm, the main breathing muscle, making non-invasive mechanical ventilation necessary throughout the night and for several hours during the day.[1] The man had long suffered from severe inflammation of the gallbladder, complicated by gallstones and repeated infections; previous treatments, including the placement of drains, had not solved the problem.[1][2] Other healthcare facilities had judged the operation too risky, because of the danger of serious pulmonary complications and difficulty in recovering independent breathing after any general anaesthesia.[2]
The operation
The solution was found by the teams of General and Oncological Surgery, led by Alessandro Ferrero, and of Anaesthesia and General Intensive Care, led by Fabrizio Racca. The operation was performed by surgeon Marco Palisi and anaesthetist Simone Ceci.[1][2] The procedure, a laparoscopic cholecystectomy, lasted about three hours, partly because of significant adhesions and anatomical changes caused by the repeated inflammatory episodes.[1] Non-invasive ventilation support was kept active throughout the operation, avoiding both general anaesthesia and intubation.[2]
"The real complexity of this case was not just the surgery itself, but the very possibility of carrying it out without further compromising the patient's respiratory function," explain Palisi and Ceci, stressing that the strategy adopted was "the result of a multidisciplinary assessment and very close cooperation between surgery and anaesthesia."[1] For Franca Dall'Occo, general manager of the Ordine Mauriziano Hospital Trust, the case shows the hospital's ability to offer treatment opportunities to patients for whom clinical conditions seem to rule out surgery.[1][2]
Sources
- Affetto da una rara malattia neuromuscolare, operato da sveglio al Mauriziano — Il Torinese, 12 November 2026
- Paziente con una rara malattia neuromuscolare operato da sveglio al Mauriziano, intervento di tre ore senza anestesia generale — CronacaQui Torino, 12 November 2026