The specialists of the oncological division of the Neurosurgical Center performed an operation on tumor elimination in patients being awaken.
On October 02, 2014 the specialists of the Federal Neurosurgical Center have performed an operation on elimination of intracerebral tumor of the right parietal lobe in patient with frequent epileptic seizures. The tumor was placed close to functional brain zone responsible for movements of left hand and leg and caused seizures.
Awake Surgery was chosen as the method of surgical procedure allows specifying these zones precisely without damaging during the microsurgical removal. At the main stage of the operation the patient was awaken, she could talk, was able to perform some simple actions (such as to move the hand or leg). Neurologist determined the strength and volume of such movements on all the stages of tumor removal.
This type of surgery takes considerable time, demands special skills and knowledge from the whole team of doctors, first of all from anesthesia care providers, neurophysiologists, neurologists and neurosurgeons.
The necessity of a patient’s awakening during the neurosurgical procedure states some unusual challenges for an anesthesia care provider. As a rule, to make comfort for a patient and ease for a surgeon, it’s necessary to cast a patient into deep sleep to avoid any emotional response to the current developments.
During an ordinary surgical procedure, for a successful profound anesthesia and controlled respiration, the patient is given such medical products that can relax muscles. They exclude any patient’s movements. However, an ordinary set of anesthetic management changes when there is a necessity of speech and movements control during the procedure. In spite of variety of modern monitoring methods, such simple control is also the most powerful method of retaining language and movement functions after removal of brain tumors.
In some cases musicians are given instruments to control their ability to play music. The goal of an anesthesia care provider is to awake the patient gently during the surgical procedure and to maintain the ability of a patient to talk and fulfil simple commands with underlying adequate anesthesia. After delimiting the edge of functional zones, surgical procedure continues under ordinary anesthesia. Such method of anesthetic management is possible only in case of existence of high quality tracking and monitoring devices, modern general anesthetics and experienced specialists.
The staff of surgical team undertook a special internship in the leading hospitals of Japan. In Russia such types of surgical procedures are rare and are held in the leading neurosurgical institutes (The Academician N.N.Burdenko Research Institute of Neurosurgery (Moscow)). In Novosibirsk this type of surgical procedure was performed for the 1st time.
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