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Monday, December 28, 2009

SKMC Surgeons Perform the first State of the Art Awake Brain Surgery for a 38-year Old Patient

Posted on: Monday December 28 , 2009 12:35:00 PM (GMT+4)

  • Surgery First of Its Kind in the Gulf Region
The patient was admitted with several epileptic fits, post-critical transient aphasia and hemiparesis. Investigations including CT scan and MRI of the brain showed a left frontal cortico-subcortical tumor, which is in the brain area responsible for the speech. A biopsy was then done on this lesion; and the histopathology report showed an Astrocytoma which is an intermediate tumor between benign and malignant.

Dr. Maher Mansour, Consultant Neurosurgeon who performed this state-of-the-art surgery, stated “The first line treatment of this kind of tumors is the surgical excision or at least partial excision of the lesion in order to reduce its volume and the mass effect on the brain”.

“The surgery for this 38 year old patient was conditioned by the risk of post-op aphasia (inability to speak). For that reason, it was indicated to do this procedure with the patient awake, in order to assess him while we do electrical stimulation on the region we wanted to remove ensuring that no cells from the normal brain is removed”, Dr. Mansour added.

The surgery was made possible because of the multi-disciplinary team involved, which was led by Dr. Maher Mansour, who practices surgery in SKMC since coming from France in 2006. In addition, Dr. John Mansfield, Chairman of Anesthesia at SKMC, Dr. Adham El Sayed were amongst the team as well as Dr. Alan Smit, Dr. Peter Kelsall and Dr Sayed Zaidi who provided the patient with local anesthesia and conscious sedation.

During the surgery, assessment of the patient speech through very specific tests repeated three times for each stimulated area (gyrus) was performed very professionally by the speech therapy team, Mershen Pillay and Fatima-Nouzha Ishak. Technical assistance for the cortical stimulation was also assured during the surgery.

Dr. Mansour added, “The patient tolerated this 6 hours procedure very well and he was speaking and moving on the OR table after the last suture”.

The post-operative images of the patient brain showed that the tumor was totally removed and the brain was under normal pressure. However, the histopathology analysis of the tumor showed Grade 3 Astrocytoma, therefore the patient needed complementary radiation therapy which he decided to have in his home country, India.

The patient was discharged from SKMC 10 days after the surgery. Staff members from intensive care unit, social work, nursing, pharmacy were also significantly involved during the patient’s hospital stay.

“We are pleased that we were able to totally remove the tumor from the brain and that the patient is currently doing well speaking and moving freely with no pain”, Dr. Mansour added. “We are proud that we expanded our capabilities to perform this brain surgery for an awake patient successfully at SKMC which is considered the first of its kind in the gulf region”.

“This attainment demonstrates the Abu Dhabi Health Services Company – SEHA and SEHA commitment to delivering world class healthcare services to our patients. In addition, it demonstrates SKMC and Cleveland Clinic’s commitment to improving the lives of patients through innovation,” said Carl Stanifer, SEHA CEO. “SKMC is setting new standards of care and building patient trust in the healthcare system. I’m extremely proud of the team who worked tirelessly to save this patient’s life”.

Dr. Tej Maini, CEO of SKMC said, “We are proud of our team who performed this successful and quite challenging surgery although there was no guarantee that the total excision of the tumor was going to be ultimately successful, given its extreme advanced nature and sensitive location in the brain. It’s important to emphasize how remarkable it was to have more than 20 people working together in such a coordinated and orchestrated way to ensure the best possible outcome for this patient. At the same time, one of the most rewarding experiences for us is to see this patient recover after the removal of the tumor and return home in a healthier condition with normal vocalization”.

“This demonstrates SKMC and Cleveland Clinic’s commitment to embrace state-of-the-art medical and surgical practices that allow our surgeons to advance the standard of care for their patients in a regionally reputed medical center offering the best treatment and facilities”, Dr. Maini said.

Dr. Atul Mehta, Chief Medical Officer of SKMC, said that “Like other rare and cutting-edge surgeries, the surgeons at SKMC constantly endeavor to innovate and create new avenues of patient care by pioneering procedures across the UAE”.
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