A surgical team at Rajiv Gandhi Government General Hospital (RGGGH), Chennai has completed the city’s first cross-hand replantation procedure, a complex operation involving the reattachment of hands crossed between limbs.
Cross-hand replantation refers to the surgical reconnection of hands when one or both are severed and then transplanted to the opposite arm side. For example, the right hand may be replanted onto the left arm and vice versa. This complex microsurgical procedure demands reconnection of bones, tendons, nerves, arteries, veins, and soft tissues under magnification.
At RGGGH, a multidisciplinary team of plastic surgeons, orthopaedic surgeons, vascular surgeons, microsurgeons, and anesthesiologists performed the operation. The hospital’s infrastructure and prior experience with hand and limb reattachment facilitated the undertaking.
The patient, a 28-year-old migrant laborer from Bihar, sustained severe injuries to both upper limbs in a train accident near Park Railway Station on September 26. He was brought to Rajiv Gandhi Government General Hospital (RGGGH) with his left arm amputated near the shoulder which was too crushed to be replanted and a severely damaged right hand that had lost all fingers.
To prevent total loss of both upper limbs, the surgical team at RGGGH, under the guidance of Dean Dr. E. Shantharaman, decided to undertake a cross-hand replantation procedure. In this innovative surgery, the amputated left hand was attached to the right forearm stump, aiming to restore at least one functional upper limb.
Cross-hand replantation is rare globally, typically undertaken in specialized centers. The success of such surgery can restore not just structure but functional utility—allowing patients partial or full use of transplanted limbs. Chennai’s successful attempt adds to the surgical capacity of government hospitals in India, especially for advanced reconstructive microsurgery.
This operation is particularly challenging because:
The vascular reconnection must ensure adequate blood flow in tissues to prevent necrosis.
Nerve regeneration is slow and unpredictable, and functional recovery may take months to years.
Tendon and muscle repairs require precise alignment for eventual motion.
Rehabilitation and physiotherapy are critical for recovery of grip, extension, and fine motor control.1
Outcomes depend heavily on post-operative care, infection control, and rehabilitation protocols.1
Last year, RGGGH surgeons performed a dual hand reattachment of a woman whose hands were nearly amputated by her son.2 The operation lasted about eight hours, involving reconstruction of blood vessels, nerves, and tendons. The patient was placed in intensive care and later began rehabilitative therapy. This previous success provided surgical experience and teamwork that likely supported the cross-hand replantation effort.
References
Sabapathy, S. Raja, Hari Venkatramani, Sanjai Ramkumar, Monusha Mohan, and Dafang Zhang. “Cross-Hand Replantation.” Indian Journal of Plastic Surgery 53, no. 1 (2020): 124–130. https://pmc.ncbi.nlm.nih.gov/articles/PMC7192695/.
“Miraculous Surgical Effort Saves Woman’s Hands.” Times of India, December 23, 2024. https://timesofindia.indiatimes.com/city/chennai/miraculous-surgical-effort-saves-womans-hands/articleshow/116608553.cms.
(Rh/Eth/TL/MSM)