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guidance is used in every case, skin and the bone incision as planned as a
minimum invasive procedure, usually less than 5 cm. Brain is exposed always
under the microscope, and the tumor is gently separated from the normal tissue,
preserving normal arteries and veins. Monitoring of brain eloquent areas used
if needed.
How
is Craniotomy for Brain Tumor Resection performed?
This
procedure is done for tumor inside the brain, like gliomas or brain metastasis,
and tumors in the covering layers, like meningioma and schwannoma. Some cases
are benign tumors, and the surgery can be curative, but other are aggressive
and need adjuvant treatments as radiotherapy and chemotherapy. It is done in
adults and also in children, for some brain tumors in children, surgery is the
cornerstone of treatment.
Maximum
safe resection of the tumors is the goal: complete resection without
neurological deficit gives patients the biggest benefit in survival and quality
of life.
Most brain tumors are resected under general anesthesia. In some cases, we
need to check the integrity of neurological functions during the surgery. Neurophysiological
monitoring techniques are able to provide that information, usually with the
patient slept. For checking certain functions, like language, patients need to
be awake during all or part of the surgery, this can also be done in our
center, while keeping the patient with good comfort.
Resection of brain tumors is an open surgery, no robotic surgery nor
lasers are routinely in use. However, we
do surgery in a minimally invasive way using always microscope for
magnification and navigation to target the tumor through the smallest approach
possible. With experience, proper technology, and careful planning of every case,
most of the brain tumors can be reached and resected through by natural,
anatomic corridors, with minimal distortion of the normal tissue. The
microscope is the main tool in every case, and it has different fluorescent
filters. The characteristics of some
tumors allow to identify them better under fluorescent light in the surgical
field, is a kind of augmented reality. We have extensive experience with
fluorescence guided resection. Endoscope can be used in some cases, to see
around the corners, and help with the resection.
Author: Dr.Ricardo Díez Valle
Posted: 28 October 2019 2019 at 10:21
UTC
Last Updated: 07 November 2019 at 09:33 UTC