KUWAIT: A Kuwaiti surgeon has successfully carried out an operation to remove a tumor from the brain of a patient while she was awake. Dr Hesham Al-Khayat led the team that operated on the patient, a Syrian, in Ibn Sina Hospital days after she was unable to speak properly coupled with weakness in the right side of her body. The operation, performed in a selected number of hospitals around the world, is known as an awake craniotomy, during which the surgeon removes part of the bone from the skull to expose the brain while the patient is awake. The patient was unable to utter words properly and could not think right. Her condition worsened and she could not read nor ambulate.
During surgery, the neurosurgeon used brain-mapping techniques to identify and avoid injury to areas of the brain that control language, motor and sensory function. "Mapping techniques using mild electrical current are employed to locate the precise areas that control specific skills such as speech, all while the patient is awake in the operating room," Dr Al-Khayat said in a statement. "If the mild stimulation hinders the task of speaking, reading or moving, that area of the brain is marked and left untouched," he added as he explained the process of the surgery.
Al-Khayat said that such procedure entailed a carefully-orchestrated team approach between the neurosurgeon, the neurophysiologist, anesthesiologist and a helpful patient. This operation depends on local block of 12 nerves that supply the scalp, such technique will allow application of a pin head and to do scalp incision with craniotomy pain-free. The surgeon then injects the layer that cover brain with local anesthesia.
"The dissection and excision of tumor in the brain are painless," explained Al-Khayat. Anesthesia team administers analgesic and tranquilizer medication to decrease pain and anxiety, thus facilitate the patient's cooperation during the procedure. During the procedure, an electronic tablet device is used to show the patient various pictures and scenes. The patient has to name the pictures or explain the scenes. This will help localize various eloquent area in the brain such as motor or speech center.
Such localization will help surgeon choose track to reach tumor away from eloquent area and will facilitate complete excision of tumor without any morbidity, he pointed out. "The procedure took only one and a half hours and she regained her speech and strength. The tumor was excised grossly," said Al-Khayat. He thanked the anesthesia, neurophysiology and neurosurgery teams as well as the whole nurse staff for performing the 100-percent awake craniotomy surgery, enabling removal of the whole tumor from an eloquent speech area safely and quickly. - KUNA