Calcutta, Oct. 9: The brief was regular: open heart surgery to rectify a congenital defect. But the condition of M. Biswas was not.

The 44-year-old, who came from Bangladesh, had a very bad lung condition, which set the doctors thinking.

?With his lungs in a bad shape, we knew it would be a big risk if we put him on ventilator during surgery. We decided to go for an unconventional procedure,? said Ajay Kaul, director of the cardiac surgery department at the B.M. Birla Heart Research Centre.

In a first for Calcutta, the team of surgeons put Biswas under the scalpel without general anaesthesia or ventilation.

Last Wednesday, a 0.6 mm catheter was inserted between his first and second vertebrae to administer medicines during surgery. The next day, Biswas was in the operation theatre with a special mask for oxygen inhalation.

During surgery, he was put on a heart-lung machine, but he was in his senses. Only his torso was anaesthetised.

?After the surgery, he was sitting up and talking to his relatives,? said Kaul, who led the surgery.

Earlier this week, Dr Buddhadeb Chatterjee at Apollo Gleneagles Hospital performed another complicated surgery.

Sixty-five-year-old Pushparani Samanta was admitted for replacement of both knees. She had several complications, particularly severe diabetes.

?It was a catch-22 situation for Samanta, who was confined to bed due to arthritis but was advised to walk to control her blood sugar which had soared to 600 mg/dl. She could not get up due to her knees and was on the verge of slipping into a coma due to her diabetes,? said Chatterjee.

Samanta first underwent insulin therapy and was taken for a five-hour operation. About 48 hours later, she took her first steps in four months.