Connect with us

Features

Thomian cricketer Sarath Seneviratne’s surgical feat in the Caymans

Published

on

A team of doctors led by Dr. Sarath de Alwis Seneviratne, Associate Professor/Senior Consultant, at CTMH, The Doctors Hospital in the Cayman Islands, recently removed a giant tumour from the uterus of a patient – the largest seen on the Cayman Islands and perhaps the world. Seneviratne was assisted by surgeons Dr Steve Tomlinson, F.R.C.S., L.R.C.P and Dr Chris Bromley, F.R.C.S. (Eng.), F.R.C.S. (Edin.). 

 

Lankan surgeon removes giant tumour in the Cayman Islands

 

A team of doctors led by Dr. Sarath Seneviratne (STC CRICKET & SPORTS FAME), Associate Professor/Senior Consultant, at CTMH The Doctors Hospital in the Cayman Islands, recently removed a giant tumour from the uterus of a patient, which was easily one of the largest tumours the doctors had ever removed, weighing in at 21 pounds 2 ounces. This was very likely the largest tumour ever seen by surgeons in the Cayman Islands and one of the largest ever seen in the world with a successful outcome. The team of medical professionals who successfully removed the tumour was led by Dr. Sarath, assisted by surgeons Dr Steve Tomlinson, FRCS, LRCP and Dr Chris Bromley, FRCS. (Eng.) and (Edin).

“The patient was presented with an abdominal mass extending to the chest and extending under the liver. She was in considerable pain and discomfort, particularly in the back, having undergone surgery previously in London “. Dr Sarath Seneviratne said. “She needed the mass to come out.”

It was anticipated that the surgery would take three hours and present challenges, given the size of the mass. Therefore Seneviratne enlisted the assistance of Drs. Tomlinson and Bromley, along with a team of experienced nurses experienced in working together as a surgical team. The approach was to ensure every measure was taken to keep the patient safe, the doctor advised.

“We anticipated difficult surgery and considerable bleeding,” Seneviratne said. “The anesthetist, Dr Stephen Gay, put in an arterial line rather than the usual venous line to help control the bleeding, as many patients have died under similar circumstances through uncontrollable blood loss, renal failure and sometimes other complications such as a coagulopathy or multiple organ failure.”

The mass was under the diaphragm and pressing against the liver, aorta and kidneys and it had gone into the pelvis; so much so that the pelvic structures could not be seen from below. The abdominal wall was enlarged vertically as well as transversely, that it looked like triplets. The lady had hypertension and weighed over 300 pounds, which added to the risks for anesthesia and surgery.

The size of the mass and intra-abdominal adhesions was the biggest difficulty, because the tumour had attached itself to various parts of the patient’s internal organs, including the small bowel, rectum, bladder and pelvic wall, hence increasing the risk of bleeding.

During the surgery, she was bleeding profusely from all sides of the tumour, especially from behind the mass. Hemostatic clamps and large warm packs were used to control the hemorrhage, while meticulously ligating the vessels.

“We had to stick to basic principles of surgery, we couldn’t do any fancy stuff,” Seneviratne said. “The basic principles are: a) you have to stop the bleeding and b) approach the tumour in such a way that she won’t bleed. Those are the two cardinal things.”

The doctors then had to move quickly to remove the mass, trying to remove it in one piece so it could be examined histologically as a whole, to look for malignancies. They kept the tumour in a large bucket before it was flown to the US to be examined. They managed to save one ovary and the patient went home three days later in good health.

“It was considered one of the biggest tumours in the world, most likely the largest ever in the Cayman Islands,” Seneviratne said.

Assisting surgeon Dr Christopher Bromley said that he had looked at the size of the patient’s stomach with some concern before they began to operate. “I could see it was going to be a substantial operation,” he confirmed.

Bromley said that the operation began smoothly and continued so with Seneviratne performing the surgery “extremely expertly”. However, when they uncovered the tumour he said he was “truly over- awed” at its size.

“It went way beyond my experience, probably the largest I had ever seen,” he said.

“It was the largest uterine fibroid that I had ever seen,” assisting surgeon Dr. Steve Tomlinson confirmed. “The surgery went like clockwork and did not take that long considering the amount of work that had to be done, especially when you consider that a normal hysterectomy takes about an hour. We had a great team – it’s really nice when a team is used to working together and can anticipate whatever the surgeon needs. Everything went very well.”

Seneviratne confirmed this: “You need a very experienced team who are on the ball because we needed 27 needles and sutures, which needed to be constantly given to the surgeon. It’s a synchronised exercise where everybody knows what they are doing. It was a great experience for the team.”

Tomlinson said the patient had told him subsequently that she had lost 32 lbs overall and was doing well now. She has already seen Seneviratne for a check-up and he confirmed she was doing well and had a very positive and cheerful outlook on her situation.

Senior Consultant Obstetrician and Gynaecologist/ Associate Professor Dr Sarath de Alwis-Seneviratne has been practicing medicine in the Caymans for 26 years, having previously practiced in the UK for 14 years. He has delivered thousands of babies and treated thousands of patients in the Cayman Islands over the years, with an unblemished record.

Also of interest is that this ground-breaking doctor has placed the Cayman Islands on the medical map by operating on a patient who was thought to be inoperable by leading cancer specialists in Florida.

Seneviratne explained: “The patient went to her general practitioner with pelvic pain. The GP did an ultrasound scan and found a six cm tumour which the doctor considered to be a possible carcinoma. The GP sent the patient to a consultant OB/GYN Board certified in the USA, who did a CT scan which confirmed the mass. The specialist doctor suspected a malignancy and sent the patient to Baptist Hospital in Florida to one of the best doctors in the world.”

In the USA, the doctors did an MRI and booked the patient in for surgery, but during the surgery, they had a lot of trouble and could not find the tumour because it was not easily accessible. Having spent thousands of dollars up until this point, the patient finally came back to the Caymans with the tumour still inside her.

” We did a scan in my surgery and I identified the tumour to be about six or seven centimeters,” Seneviratne said. “I took her to the operating room and put her under the laparoscope. I do this special technique where I insert a rigid catheter into the bladder and shake the catheter. When the catheter was shaken only the top of the bladder was shaking not the entire bladder, which meant that the tumour was under the bladder. This is an extremely rare presentation and cannot be seen if you just look through a telescope and have a look. I then went under the bladder and removed the tumour, from between the ureters.”

He said that the tumour was bigger than the uterus and the tubes and ovaries put together.

“After two days in the hospital she went home and the biopsy was benign and now she is happy and well,” he confirmed.

Seneviratne is involved in innumerable charities in the Cayman Islands, Sri Lanka and in the Philippines, albeit anonymously. Recently he provided dry rations for the villages around his ancestral home to 750 families.

Dr. Seneviratne’s ualifications include FRCS(Edin), FRCOG(GB), MRCP(Ire), FFSRH(GB), FACOG(USA), MS.(SL), MRCS/LRCP(GB), LRCP/LRCP&S(Edin) and a whole host of other diplomas and memberships. He has a laparoscopic entry method named after him, a suture technique for suturing the vagina and an efficient posture for examination of a prolapsed uterus.

As a fine sportsman here, he captained Sri Lanka cricket President’s Eleven against Malaysia; he headed the national batting, averages in 1976, captained Sri Lanka against Agra at hockey after the New Delhi tournament in India and was awarded the Sports Star trophy at the university. He captained the Colombo and Combined University cricket teams. He captained STC and Combined Schools cricket in 1965. He also represented the Nation in hockey at the Asian Games in Thailand.

Interestingly, he top-scored each time he played against foreign teams. This included the match against State Bank of India, captained by Ajith Wadekar, where the National team was captained by the famous Stanley Jayasinghe. He scored half a century facing up to Venkatarhagavan and V.V.Kumar who were considered to be the best spinners in the world at that time.

He top-scored with half a century, in the Gopalan Trophy match playing for the team captained by Anura Tennakoon; he top-scored against the Australian team captained by Bill Lawry on a wet wicket, in a low scoring match in Kandy. 

 

ESTO PERPETUA



Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Features

Ranking public services with AI — A roadmap to reviving institutions like SriLankan Airlines

Published

on

Efficacy measures an organisation’s capacity to achieve its mission and intended outcomes under planned or optimal conditions. It differs from efficiency, which focuses on achieving objectives with minimal resources, and effectiveness, which evaluates results in real-world conditions. Today, modern AI tools, using publicly available data, enable objective assessment of the efficacy of Sri Lanka’s government institutions.

Among key public bodies, the Supreme Court of Sri Lanka emerges as the most efficacious, outperforming the Department of Inland Revenue, Sri Lanka Customs, the Election Commission, and Parliament. In the financial and regulatory sector, the Central Bank of Sri Lanka (CBSL) ranks highest, ahead of the Securities and Exchange Commission, the Public Utilities Commission, the Telecommunications Regulatory Commission, the Insurance Regulatory Commission, and the Sri Lanka Standards Institution.

Among state-owned enterprises, the Sri Lanka Ports Authority (SLPA) leads in efficacy, followed by Bank of Ceylon and People’s Bank. Other institutions assessed included the State Pharmaceuticals Corporation, the National Water Supply and Drainage Board, the Ceylon Electricity Board, the Ceylon Petroleum Corporation, and the Sri Lanka Transport Board. At the lower end of the spectrum were Lanka Sathosa and Sri Lankan Airlines, highlighting a critical challenge for the national economy.

Sri Lankan Airlines, consistently ranked at the bottom, has long been a financial drain. Despite successive governments’ reform attempts, sustainable solutions remain elusive.

Globally, the most profitable airlines operate as highly integrated, technology-enabled ecosystems rather than as fragmented departments. Operations, finance, fleet management, route planning, engineering, marketing, and customer service are closely coordinated, sharing real-time data to maximise efficiency, safety, and profitability.

The challenge for Sri Lankan Airlines is structural. Its operations are fragmented, overly hierarchical, and poorly aligned. Simply replacing the CEO or senior leadership will not address these deep-seated weaknesses. What the airline needs is a cohesive, integrated organisational ecosystem that leverages technology for cross-functional planning and real-time decision-making.

The government must urgently consider restructuring Sri Lankan Airlines to encourage:

=Joint planning across operational divisions

=Data-driven, evidence-based decision-making

=Continuous cross-functional consultation

=Collaborative strategic decisions on route rationalisation, fleet renewal, partnerships, and cost management, rather than exclusive top-down mandates

Sustainable reform requires systemic change. Without modernised organisational structures, stronger accountability, and aligned incentives across divisions, financial recovery will remain out of reach. An integrated, performance-oriented model offers the most realistic path to operational efficiency and long-term viability.

Reforming loss-making institutions like Sri Lankan Airlines is not merely a matter of leadership change — it is a structural overhaul essential to ensuring these entities contribute productively to the national economy rather than remain perpetual burdens.

By Chula Goonasekera – Citizen Analyst

Continue Reading

Features

Why Pi Day?

Published

on

International Day of Mathematics falls tomorrow

The approximate value of Pi (π) is 3.14 in mathematics. Therefore, the day 14 March is celebrated as the Pi Day. In 2019, UNESCO proclaimed 14 March as the International Day of Mathematics.

Ancient Babylonians and Egyptians figured out that the circumference of a circle is slightly more than three times its diameter. But they could not come up with an exact value for this ratio although they knew that it is a constant. This constant was later named as π which is a letter in the Greek alphabet.

Archimedes

It was the Greek mathematician Archimedes (250 BC) who was able to find an upper bound and a lower bound for this constant. He drew a circle of diameter one unit and drew hexagons inside and outside the circle such that the sides of each hexagon touch the sides of the circle. In mathematics the circle passing through all vertices of a polygon is called a ‘circumcircle’ and the largest circle that fits inside a polygon tangent to all its sides is called an ‘incircle’. The total length of the smaller hexagon then becomes the lower bound of π and the length of the hexagon outside the circle is the upper bound. He realised that by increasing the number of sides of the polygon can make the bounds get closer to the value of Pi and increased the number of sides to 12,24,48 and 60. He argued that by increasing the number of sides will ultimately result in obtaining the original circle, thereby laying the foundation for the theory of limits. He ended up with the lower bound as 22/7 and the upper bound 223/71. He could not continue his research as his hometown Syracuse was invaded by Romans and was killed by one of the soldiers. His last words were ‘do not disturb my circles’, perhaps a reference to his continuing efforts to find the value of π to a greater accuracy.

Archimedes can be considered as the father of geometry. His contributions revolutionised geometry and his methods anticipated integral calculus. He invented the pulley and the hydraulic screw for drawing water from a well. He also discovered the law of hydrostatics. He formulated the law of levers which states that a smaller weight placed farther from a pivot can balance a much heavier weight closer to it. He famously said “Give me a lever long enough and a place to stand and I will move the earth”.

Mathematicians have found many expressions for π as a sum of infinite series that converge to its value. One such famous series is the Leibniz Series found in 1674 by the German mathematician Gottfried Leibniz, which is given below.

π = 4 ( 1 – 1/3 + 1/5 – 1/7 + 1/9 – ………….)

The Indian mathematical genius Ramanujan came up with a magnificent formula in 1910. The short form of the formula is as follows.

π = 9801/(1103 √8)

For practical applications an approximation is sufficient. Even NASA uses only the approximation 3.141592653589793 for its interplanetary navigation calculations.

It is not just an interesting and curious number. It is used for calculations in navigation, encryption, space exploration, video game development and even in medicine. As π is fundamental to spherical geometry, it is at the heart of positioning systems in GPS navigations. It also contributes significantly to cybersecurity. As it is an irrational number it is an excellent foundation for generating randomness required in encryption and securing communications. In the medical field, it helps to calculate blood flow rates and pressure differentials. In diagnostic tools such as CT scans and MRI, pi is an important component in mathematical algorithms and signal processing techniques.

This elegant, never-ending number demonstrates how mathematics transforms into practical applications that shape our world. The possibilities of what it can do are infinite as the number itself. It has become a symbol of beauty and complexity in mathematics. “It matters little who first arrives at an idea, rather what is significant is how far that idea can go.” said Sophie Germain.

Mathematics fans are intrigued by this irrational number and attempt to calculate it as far as they can. In March 2022, Emma Haruka Iwao of Japan calculated it to 100 trillion decimal places in Google Cloud. It had taken 157 days. The Guinness World Record for reciting the number from memory is held by Rajveer Meena of India for 70000 decimal places over 10 hours.

Happy Pi Day!

The author is a senior examiner of the International Baccalaureate in the UK and an educational consultant at the Overseas School of Colombo.

by R N A de Silva

Continue Reading

Features

Sheer rise of Realpolitik making the world see the brink

Published

on

A combined US-Israel attack on Iran.(BBC)

The recent humanly costly torpedoing of an Iranian naval vessel in Sri Lanka’s Exclusive Economic Zone by a US submarine has raised a number of issues of great importance to international political discourse and law that call for elucidation. It is best that enlightened commentary is brought to bear in such discussions because at present misleading and uninformed speculation on questions arising from the incident are being aired by particularly jingoistic politicians of Sri Lanka’s South which could prove deleterious.

As matters stand, there seems to be no credible evidence that the Indian state was aware of the impending torpedoing of the Iranian vessel but these acerbic-tongued politicians of Sri Lanka’s South would have the local public believe that the tragedy was triggered with India’s connivance. Likewise, India is accused of ‘embroiling’ Sri Lanka in the incident on account of seemingly having prior knowledge of it and not warning Sri Lanka about the impending disaster.

It is plain that a process is once again afoot to raise anti-India hysteria in Sri Lanka. An obligation is cast on the Sri Lankan government to ensure that incendiary speculation of the above kind is defeated and India-Sri Lanka relations are prevented from being in any way harmed. Proactive measures are needed by the Sri Lankan government and well meaning quarters to ensure that public discourse in such matters have a factual and rational basis. ‘Knowledge gaps’ could prove hazardous.

Meanwhile, there could be no doubt that Sri Lanka’s sovereignty was violated by the US because the sinking of the Iranian vessel took place in Sri Lanka’s Exclusive Economic Zone. While there is no international decrying of the incident, and this is to be regretted, Sri Lanka’s helplessness and small player status would enable the US to ‘get away with it’.

Could anything be done by the international community to hold the US to account over the act of lawlessness in question? None is the answer at present. This is because in the current ‘Global Disorder’ major powers could commit the gravest international irregularities with impunity. As the threadbare cliché declares, ‘Might is Right’….. or so it seems.

Unfortunately, the UN could only merely verbally denounce any violations of International Law by the world’s foremost powers. It cannot use countervailing force against violators of the law, for example, on account of the divided nature of the UN Security Council, whose permanent members have shown incapability of seeing eye-to-eye on grave matters relating to International Law and order over the decades.

The foregoing considerations could force the conclusion on uncritical sections that Political Realism or Realpolitik has won out in the end. A basic premise of the school of thought known as Political Realism is that power or force wielded by states and international actors determine the shape, direction and substance of international relations. This school stands in marked contrast to political idealists who essentially proclaim that moral norms and values determine the nature of local and international politics.

While, British political scientist Thomas Hobbes, for instance, was a proponent of Political Realism, political idealism has its roots in the teachings of Socrates, Plato and latterly Friedrich Hegel of Germany, to name just few such notables.

On the face of it, therefore, there is no getting way from the conclusion that coercive force is the deciding factor in international politics. If this were not so, US President Donald Trump in collaboration with Israeli Rightist Premier Benjamin Natanyahu could not have wielded the ‘big stick’, so to speak, on Iran, killed its Supreme Head of State, terrorized the Iranian public and gone ‘scot-free’. That is, currently, the US’ impunity seems to be limitless.

Moreover, the evidence is that the Western bloc is reuniting in the face of Iran’s threats to stymie the flow of oil from West Asia to the rest of the world. The recent G7 summit witnessed a coming together of the foremost powers of the global North to ensure that the West does not suffer grave negative consequences from any future blocking of western oil supplies.

Meanwhile, Israel is having a ‘free run’ of the Middle East, so to speak, picking out perceived adversarial powers, such as Lebanon, and militarily neutralizing them; once again with impunity. On the other hand, Iran has been bringing under assault, with no questions asked, Gulf states that are seen as allying with the US and Israel. West Asia is facing a compounded crisis and International Law seems to be helplessly silent.

Wittingly or unwittingly, matters at the heart of International Law and peace are being obfuscated by some pro-Trump administration commentators meanwhile. For example, retired US Navy Captain Brent Sadler has cited Article 51 of the UN Charter, which provides for the right to self or collective self-defence of UN member states in the face of armed attacks, as justifying the US sinking of the Iranian vessel (See page 2 of The Island of March 10, 2026). But the Article makes it clear that such measures could be resorted to by UN members only ‘ if an armed attack occurs’ against them and under no other circumstances. But no such thing happened in the incident in question and the US acted under a sheer threat perception.

Clearly, the US has violated the Article through its action and has once again demonstrated its tendency to arbitrarily use military might. The general drift of Sadler’s thinking is that in the face of pressing national priorities, obligations of a state under International Law could be side-stepped. This is a sure recipe for international anarchy because in such a policy environment states could pursue their national interests, irrespective of their merits, disregarding in the process their obligations towards the international community.

Moreover, Article 51 repeatedly reiterates the authority of the UN Security Council and the obligation of those states that act in self-defence to report to the Council and be guided by it. Sadler, therefore, could be said to have cited the Article very selectively, whereas, right along member states’ commitments to the UNSC are stressed.

However, it is beyond doubt that international anarchy has strengthened its grip over the world. While the US set destabilizing precedents after the crumbling of the Cold War that paved the way for the current anarchic situation, Russia further aggravated these degenerative trends through its invasion of Ukraine. Stepping back from anarchy has thus emerged as the prime challenge for the world community.

Continue Reading

Trending