Doctors talks patient through brain surgery

New Delhi, Aug 23 (UNI) For 33-year-old Abdur Rahman Prodhani, who was diagnosed with malignant brain tumor a few months ago, future did not hold much promise.

The Saudi-based software professional was facing either imminent death or permanent loss of functioning of face and left arm and leg in case the growth was removed by normal anesthesia surgery.

The tumor was located in the 'motor strip'-- the area of the brain controlling body movements.

Considering the high risk the patient was facing, doctors at Apollo Hospital, where he went to seek treatment, opted for very rare procedure -- 'Awake Craniotomy' or a neuro surgery during which the patient is fully awake-- which would result in minimising the deficit and at the same time remove the growth to the maximum.

''The main concern during any surgery on the brain is how we can best preserve the person's level of functioning...

This is especially important when an abnormality such as brain tumor lies close to an area of the brain which controls the vital functions like speech movement etc,'' said Neurosurgeon Dr V P Singh, who operated upon Abdur for over three-and-a- half-hours on July 5.

''The basis of the operation is the fact that the brain has no pain sensitive structures... So although the brain is the organ responsible for feeling even the minutest pain-- it itself is not pain sensitive. One can handle the brain surface, cut it, remove the tumor without any pain,'' he added.

The purpose of the surgery is to have an awake patient which would reduce the operative risk of damaging the vital areas and also achieving maximum tumor resection by simultaneous probing of the surrounding eloquent regions, thus identifying them and avoiding them, the doctor explained.

''This is a very rare procedure which requires a very cooperative patient... who knows what will happen and has full faith in the doctors. At the same time the doctors have to be highly skilled to perform the procedure as the patient is not still all through it,'' Dr Singh said.

Today, Abdur, who has almost full use of his face and limbs and 60 per cent of his tumor is removed, recommends the procedure to all patients who have a similar condition.

''I was not at all scared... I had full faith in the doctors.

I am glad I will be resuming my normal life very soon,'' said Abdur, whose surgery was captured on camera and shown to journalists.

''When we came here and got to know about the procedure at that time I had apprehensions but the doctors allayed all of them... Overall I had a good experience,'' he added.

Emphasising that the patient's safety is not compromised at any stage during the operation, Neuro Anesthetist Dr K J Choudhary said Abdur's vitals were monitored through the procedure and at the same time it is ensured that his functioning is normal.

''This is the special aspect of the procedure... The moment the functioning of the patient is affected we stop. The special skill of numbing only specific nerves is used,'' he said.

However, some residual tumor was left in Abdur which is being treated by radiotherapy now.

Dr Choudhary said had the patient been operated under general anesthesia-- the doctors would not have known when they were causing damage to the speech area and would have continued to remove the tumor.

''By performing awake craniotomy, they knew exactly when the deficit started and stopped further removal of the tumor, thus facilitating recovery of function with time,'' he added.

UNI