The patient was admitted to the Critical Care Unit (CCU) at Inamdar Multispeciality Hospital on 1/3/26 under Dr. Amit Mazumdar with a sudden onset of breathlessness and severe oxygen desaturation following the consumption of outside food. She was a high-risk case, with multiple co-morbidities including morbid obesity, diabetes, and multinodular toxic goiter, and was also diagnosed with pneumothorax.

Initial Management (Date: 4/3/26)

An intercostal drainage (ICD) tube was inserted to manage the pneumothorax. The patient was stabilised and maintained on ventilatory support, with a trial on T-piece conducted after initial improvement.

Failed Extubation Attempts (Dates: 5/3/26 / __)

Despite meeting extubation parameters, two separate attempts to wean her off ventilatory support failed due to persistent desaturation, necessitating re-intubation. The inability to sustain spontaneous breathing raised the need for a definitive airway solution.

At this stage, the treating team explained the need for tracheostomy and thyroidectomy to the family. Given the perceived risks associated with thyroid surgery, the relatives initially consented only to tracheostomy, which was considered semi-urgent.

Intraoperative Turning Point (Date of Surgery: 9/3/26)

During surgery at Inamdar Multispeciality Hospital, doctors encountered a critical anatomical challenge. The patient had a massively enlarged thyroid gland extending retrosternally and completely engulfing the trachea, making tracheostomy technically impossible without first removing the thyroid.

This intraoperative finding necessitated an immediate change in surgical plan. The patient’s relatives were counselled again in real time regarding the urgency and inevitability of proceeding with thyroidectomy.

The surgery was led by Dr. Pravin Bhosale, ENT Surgeon, with support from the general surgery team—Dr. Nelson and Dr. Abhijeet Gotkhinde, while the anaesthesia team comprising Dr. Sandeep Patil and Dr. Jyoti Sawant ensured stable intraoperative management.

Following thyroid removal, the team conducted critical intraoperative assessments. The integrity of both recurrent laryngeal nerves was confirmed, the parathyroid glands were preserved, and there was no evidence of tracheomalacia.

Critical Surgical Decision

Based on these findings, the team made a decisive call to avoid tracheostomy and attempt controlled extubation.

Dr. Pravin Bhosale, ENT Surgeon, said, “This was a highly critical case because what appeared to be a routine need for tracheostomy turned into a complex airway emergency inside the operating theatre. The thyroid was massively enlarged and retrosternal, completely engulfing the trachea, leaving no safe option except to change the surgical plan immediately. In such situations, precise judgment, timing, and coordinated teamwork are absolutely crucial to achieving a successful outcome.”

Post-Operative Recovery (Date: 10/3/26)

The patient’s recovery was notably rapid. She required only two days of CCU care post-surgery. Swallowing function was assessed using bedside FEES (Functional Endoscopic Evaluation of Swallowing), following which all supportive lines and tubes, including Ryle’s tube, catheter, and surgical drains, were removed in a phased manner.

Discharge and Outcome (Date of Discharge: 14/3/26)

The patient was discharged in stable condition, marking a successful outcome in what doctors at Inamdar Multispeciality Hospital describe as a rare convergence of airway compromise and endocrine pathology.

Reflecting on her experience, the patient said, “I was struggling to breathe, and it was a very difficult time for my family and me. The doctors explained every step and gave us confidence throughout. I feel grateful to have recovered and to be going home.”

The case involved a multidisciplinary effort, with contributions from Dr. Mulla (Endocrinologist), Dr. Ajinkya Gulave, and Dr. Vrushali (Pulmonologists), along with ICU teams, operation theatre staff, and hospital support departments.

Clinical Significance

Doctors involved in the case emphasised that such outcomes depend heavily on real-time intraoperative judgment, multidisciplinary coordination, and the ability to adapt surgical strategy based on evolving clinical findings.

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The lab’s essence lies in its ability to visually represent and explain medical conditions to patients in real-time and through physical 3D models to offer better treatment modalities. For instance, instead of relying solely on imaging diagnostics, a tangible 3D figure can be presented to provide immediate and hands-on insight into the nature of a lower jaw tumour. The lab offers advanced medical 3D design and printing services, including pre-surgical planning and education, the creation of patient-specific cutting and drilling guides, and the development of customized implants and implant moulds. These capabilities are poised to enhance precision in surgeries, leading to improved clinical outcomes.

The diverse benefits of utilizing 3D designing and printing in healthcare include personalized pre-surgical planning, customized surgical tools and prosthesis, enhanced patient education, reduced surgical time in operation theatre, shorter hospital stay, and better clinical outcomes. The chief guest, Dr. Anand Venugopal, Chief Operating Officer, Teaching Hospitals -Manipal Academy of Higher Education (MAHE), said, “The advent of 3D designing and printing is a game-changer. It shifts the paradigm from merely analyzing images to crafting physical representations of medical conditions. This technology not only enhances patient comprehension but also revolutionizes how we approach diagnosis and treatment planning.”

The diverse benefits of utilizing 3D design and printing in the healthcare include:

• Personalised pre-surgical planning
• Customised surgical tools and prosthesis
• Enhanced patient education
• Reduced surgical time in operation theatre
• Shorter hospital stay and better clinical outcome
• Allows knowledge exchange between different centres

According to recent data, the market of 3D designing and printing technology for healthcare in India is projected to grow around 20.9% until 2030. This growth signifies a shift towards advanced and personalized medical solutions, emphasizing the positive impact of 3D technology on patient care across various medical disciplines.

Saghir Siddiqui, Regional Chief Operating Officer, KMC Hospital, Mangalore, said, “Being a prominent healthcare entity in India, Manipal Hospitals consistently invests in cutting-edge healthcare technology. Given our diverse patient base from coastal Karnataka, northern Kerala, and the Gulf region, our commitment is to provide world-class clinical services. I am delighted to announce the launch of advanced 3D designing and printing equipment for healthcare at our hospital–the first of its kind in this region. This revolutionary technology not only propels us forward but showcases our dedication to delivering the highest standards of care, personalized solutions, and leading-edge medical advancements to our community.“

This first 3D Designing and Printing Lab for Healthcare in coastal Karnataka and northern Kerala is set to transform healthcare practices by offering advanced medical 3D design and printing services. The lab’s diverse benefits include personalized pre-surgical planning, customized surgical tools and prosthesis, enhanced patient education, reduced surgical time in operation theatre, shorter hospital stay, and better clinical outcomes. This revolutionary technology not only enhances patient comprehension but also revolutionizes how we approach diagnosis and treatment planning.

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