New Delhi: Doctors at the All India Institute of Medical Sciences (AIIMS) claimed to have developed a novel technique of minimally invasive surgery to perform a complex procedure, which involves a complete unilateral hemispheric disconnection of the brain.
This procedure is sometimes required for patients especially children who have severe drug resistant epilepsy.
Announcing this at a press conference here on Thursday, Prof. P. Sarat Chandra (Professor, Neurosurgery), AIIMS, — who developed this technique that has been published in reputed journals — said: “This technique is usually performed in young children who find it difficult to tolerate large openings and blood loss.”
Conventionally, hemispherotomy is a complex surgical procedure, which involves a large cranial incision, followed a major surgery where an entire affected hemisphere is either removed or disconnected from the healthier opposite side, explained the doctor.
“The children on whom these procedures are performed are very sick, sometimes having several hundred seizures a day. This is because a whole hemisphere is diseased and is generating severe epilepsy,” noted the physician.
Explaining this new technique, the doctor said that it allows the entire procedure to be performed with the use of endoscope through an incision just of size 4X3 cm.
“In addition, the entire surgery is performed using neuro-navigation, a sophisticated computer aided device along with the use of brain suite, where MRI is performed immediately after surgery to confirm complete disconnection,” said Prof. Chandra.
Prof. Manjari Tripathi, Professor Neurology, AIIMS, who identifies patients by pre-operative work-up, said: “If we look at the anatomy of the brain, it has two hemispheres connected by the bridge of tissue. In most cases, where we perform surgery for epilepsy, the focus is just a few centimetres large. In these cases, one whole hemisphere is affected, diseased and performs no other function apart from just throwing seizures. Most of the normal functions of that hemisphere shift to the opposite side by a phenomenon called brain plasticity. Thus the patient is actually functioning on just one hemisphere.”
Prof. B.S. Sharma, Head of department of Neurosurgery noted that this department now has the largest experience with epilepsy surgery in the country. “This procedure was initially performed in five children, which was published in the reputed journal – Neurosurgery. Now we have over 15 cases, where this procedure has been performed with very good results,” he noted.
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