I am Dr. Manish Vaish, Director, Max
Dear Mr. Vimal
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When the point is of disease, damage or infection of the brain, and of the surgery to correct them, we are already wading into difficult waters! The brain is the command center and the central processing unit of the human body. It is a heavily wired zone. Sitting inside the skull, the brain resembles a snake poised in a tight, knotty coil. Imagine having to wedge between the coils with a blade to cut and remove a boil on the underside! Such being the case, a call for surgery indicates that either it is the best of the hard choices available or it is the only choice left. Even two decade ago, the hint of a brain surgery would have sounded like a death warrant to a lot of people. Not any more! Dr Manish Vaish says the point of surgery today has changed. It is no longer just about reclaiming life. It also about restoring the quality of life. “That is how far technology and medical expertise has got us.”
Brain surgery is recommended for cases including cancer, blood clotting, swelling, injury, fits and shaking palsy. The surgery is performed by a neurosurgeon with the help of an anaesthesiologist, having an advanced clinical training in anaesthesia for brain and spinal surgeries.
Stereotactic radiosurgery
The traditional Craniotomy method entails carving through the skull to locate and direct treatment to the affected part of the brain. The method has drawbacks, in that it can be inconsistent, and can result in post-operative complications and side-effects. Stereotactic radiosurgery, on the other hand, uses a GammaKnife to pinpoint radiation on the tumour, in the process, sparing the surrounding healthy tissues and reducing possible side effects. Its biggest advantage is that the procedure is completed in just one sitting.
Neuroendoscopic brain surgery
It entails threading a thin tube called an endoscope through the mouth or nose or through small incisions in the skull to access or remove the affected brain tissue. The endoscope has a light and camera on the end, and the surgery is performed with tools placed through the endoscope.
Laser interstitial thermal therapy
It is a state-of-the-art surgical technology that can destroy the tumour using heat sent through a spot-hole in the skull. For the procedure, the surgeon inserts a laser fibre into the incision and directs it to the tumour. The laser transfers heat, destroying the tumour while sparing healthy tissue surrounding it. The procedure takes under 4 hours.
Deep brain stimulation
A small battery-operated medical device called an implantable pulse generator is taped onto the skull to deliver electrical stimulation to specific areas in the brain. The development has done wonders to the treatment of the shaking palsy disease (Parkinson’s) — the disorder that invalidated the world renowned boxer, Muhammed Ali.
Imaging
By far the most notable advancement has been in the area of scanning and imaging. It is now possible for doctors to scan and project on screen the deepest recesses of the brain. In combination with remotely guided micro-surgical tools, imaging has helped vastly improve the outcome of brain surgeries in recent times.
Fully Endoscopic Trans Nasal Skull Base Surgery
Conventional neurosurgical incisions may include skin incisions, facial bone flap (craniotomy), and brain retraction, but the endoscopic trans nasal approach avoids such procedures. Without incisions, this approach provides direct access to a large number of intracranial and paranasal sinus lesions. Thus, this advanced technique decreases the chances of post surgical complications and helps in quicker recovery. This way your hospital stay as well as the management costs are also reduced.
Hybrid Microscopic and Endoscopic Intraventricular Surgery
Certain brain surgeries like tumor removal can be risky when its location is adjacent to critical structures. In such cases complete removal of the affected part without neurological deterioration can be difficult. The Microscopic and Endoscopic approach helps in visualizing tissues in places that are difficult to access directly. This reduces the chance of unrecognized residual tumor and increases the success of the surgery. With the cutting edge technology used in this technique, the risks of the surgery is minimized with almost no complications.
Hybrid Intra-OP Real Time USG with Navigation guided Awake Brain Tumor Surgery
In some cases, when there are tumors in functionally important areas of the brain, surgery may be conducted by keeping the patient awake. By this approach, the patient’s activity can be monitored in real-time during surgery. The surgeon closely monitors if there is any neurological function that is getting affected so that the surgery can be limited or stopped at that exact time. Using an Intra-op real time USG with navigation guides the surgeon to understand how much of the tumor is removed or remaining so that surgery may proceed smoothly.
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