We present to you a reallyinnovative surgery that was recently performed at the Euroclinic of Athens by our Neurosurgery team, which consists of Nikolaos Maratheftis, Director Neurosurgeon, and Evangelos Rokas, Attending Neurosurgeon, on a 38 year-old male patient diagnosed with a lesion with tumor characters in the left cerebral hemisphere. This lesion spread near particularly sensitive areas that control movement in the right hand and foot, as well as speech comprehension and speech. The lesion was deep inside the brain. The patient had a history of kidney transplantation and blood clotting disorders.
When he came to the Euroclinic of Athens, studying the patient’s file in consultation and collaboration with Dr. Stavros Kanellas, Director Anesthesiologist and Maria Saridou, Attending Anesthesiologist, we decided to perform the operation to remove this lesion, the cause of which was a glioma of possibly low malignancy.
The technique of craniotomy with the patient awake craniotomy) is an advanced neurosurgical and anesthesia technique that allows brain surgery to be performed while the patient is conscious, painless, and can speak and execute commands given by the doctors. At the same time the operation proceeds and the diseased tissues are removed from the brain.
This method requires excellent coordination of the administration of anesthetic drugs, in a delicate balance, so that the experience is not painful for the patient while at the same time he maintains his senses.At the same time, the neurosurgeon stimulates the suspicious area with a special electrode, checking whether this stimulation causes a neurological disorder such as paralysis of the hand, foot, speech disorder, patient orientation, etc.
Thus, the pathological tissue is removed from the brain as much as possible , without the slightest impact on the patient’s neurological condition.
The craniotomy on alert has been done again in Greece. In our case, however, for the first time in Greece , this technique was combined with the most advanced minimally invasive method of “mini” craniotomy.
“Mini” craniotomy is a state-of-the-art technique worldwide. The first publications on its application to a sufficient number of patients were made in 2013 and 2014 by neurosurgery centers in the USA and Israel. With this craniotomy, only a small opening is made, a hole of 2.5 cm in diameter in the skull, from where we can reach great depth and extent, without the risks involved in a normal craniotomy.
Using the neuro navigator , we direct a small special lumenused for the first time in Greece, in the affected area, and using a microscope (or an endoscope, if necessary) we remove the pathological tissue, which we send for examination. The advantage of the lumen is that the brain is not substantially compressed, while the lesion is completely removed, and the procedure is not restricted to a simple biopsy. Therefore we combine the definitive diagnosis with the treatment of the disease.
The risk of bleeding and neurological damage to the patient is minimized by the use of minimally invasive (mini) craniotomy. Especially in the case of our patient, who had disorders of the blood coagulation mechanism due to the kidney transplant he had undergone, this method was the ideal choice.
The result of the biopsy showed that it was not a tumor, but inflammatory tissue, in the context of the immunosuppression that the patient had undergone for his kidney disease. His postoperative course was excellent. He was hospitalized only for 2 days, did not suffer from pain or other discomfort, and never showed neurological damage. The swelling of the brain subsided, along with the headaches that had led him to the MRI of the brain, which had initially revealed his problem.
Indeed, thanks to these state-of-the -art techniques that our Neurosurgery team applies to the Euroclinic of Athens, we can offer the leading medical services, such as the best Neurosurgery Centers in the world. The surgeries for the removal of inaccessible brain tumors , for the removal of automatic and traumatic brain hematomas have now been done, thanks to these techniques we apply, less traumaticless traumatic, more effective and require less time of hospitalization. Even tumors that were consideredunoperative can now be safely removed. The risk of postoperative complications (bleeding, infection, neurological damage) is clearly lower with “mini” craniotomies.
It is important, in a difficult situation for our country, to know that the conditions for the provision of health services at the top level exist and flourish, thanks to the cooperation of the Administration, the Medical and Nursing staff of the Euroclinic of Athens.
Nikolaos Maratheftis
Director Neurosurgeon of the Euroclinic of Athens
www.maratheftis.gr
