BRAIN TUMOUR RESECTION
As a Neurosurgeon with a super-specialist focus on brain tumour surgery, Dr Christos Profyris, in Johannesburg, South Africa, will work-up and resect your brain tumour according to the most current international standards.
WHEN IS BRAIN TUMOUR RESECTION SURGERY NECESSARY?
Brain tumours are an abnormal growth of cells in the brain. Be it benign or malignant; a brain tumour can cause serious health problems as it compresses vital parts of the brain. This is especially true when brain tumours continue to grow.
Surgery is usually the first step in treating most benign and many malignant brain tumours and is generally the preferred treatment. As every tumour is unique Dr Christos Profyris and his team will devise a tailored surgical plan to your specific tumour with the aim of minimising surgical risk while maximising surgical resection. Depending on your tumour and your situation, the benefits of tumour surgery can include achieving a diagnosis, potential cure, improvement in quality of life, prolongation of life and/or increasing the effectiveness of other treatments used to manage your tumour.
HOW IS BRAIN TUMOUR RESECTION SURGERY DONE?
In Johannesburg, Dr Christos Profyris and his team will assess you in clinic where a comprehensive history will be taken and clinical examination will be performed. Depending on your specific tumour and presentation, a detailed workup will be undertaken. This will be tailored to your tumour and may include a combination of blood tests, visual field testing and further imaging such as magnetic resonance imaging (MRI), MR tractography (DTI), Functional MRI (fMRI), MR Navigation, MRA/MRV and Digital subtraction angiography. Other tests may also be ordered as deemed necessary.
Ultimately this testing, will allow Dr Christos Profyris to appreciate the three-dimensional architecture of your tumour and will also alert him to potential risks and dangerous areas in relation to your tumour. This is essential as all brain surgery is potentially risky and can lead to severe consequences. This workup will allow for appreciation of these risks and will help minimise risk as much as possible. Furthermore, this workup will also allow Dr Christos Profyris to devise a plan for minimal access and keyhole surgery.
In Johannesburg, Dr Christos Profyris will employ a range of intra-operative technologies that will be aimed to decrease the risk of your surgery and achieve maximal resection. These technologies include navigation, Neurosurgical microscope, 2D and 3D endoscopy, exoscope, awake craniotomy (brain mapping), intra-operative neurophysiological monitoring and intraoperative angiography.
As there are more than 120 different types of brain tumour and brain tumours can arise in any location within the brain or spinal cord the techniques vary drastically. As this is vastly complex, the following section will only emphasise basic principles involved in brain tumour surgery.
PRINCIPLES OF BRAIN TUMOUR SURGERY
In general, brain tumour surgery involves a skin incision on the scalp to expose the skull. The exact site of the incision will be selected with the use of image mapping technology which will allow for the planning of a keyhole. An opening is made in the skull and a piece of skull bone removed and is set aside so that it may be used to close the opening later. The dura mater, a membranous layer that covers the brain is then exposed and gently opened to expose the brain. Based on the pre-operative plan, critical structures such as nerves and blood vessels will be identified and protected and the tumour will be identified. The tumour is then carefully resected away from the healthy brain tissue which is protected at all times with the aim of causing minimal disruption to the healthy tissues. Following resection, the dura mater is closed, the skull bone is replaced and secured with a type of rivet, and the scalp is sutured.
Other types of procedures may differ drastically depending on the location of the tumour. For instance, removal of a pituitary tumour or anterior skull base tumour may be done through a transnasal approach. This is another type of keyhole technique that is performed by operating through the nose. A thin tube-like tool known as an endoscope is passed through the nostril and an incision is made in the sphenoid sinus at the back of the nasal cavity. Once the sphenoid sinus is opened, access to tumour is obtained and with the use of endoscopic tools, tumour can be removed through the nose.
AFTER BRAIN TUMOUR SURGERY
Following your surgery you will remain in hospital for a few days to recover and sutures will be removed at 7 to 10 days after the operation. As soon as a diagnosis is obtained from our pathologists, the results will be communicated to you. You will get a post-operative MRI following your surgery to assess tumour resection and you will be seen again in clinic following the operation. For many cases, surgery is only the first step in the treatment pathway. Once a diagnosis is established, further treatment in the form of Stereotactic Radiotherapy (Gamma Knife), Radiotherapy or Chemotherapy may be required. In Johannesburg, Dr Christos Profyris works with a team of expert oncologists who will be consulted and will aid in planning further treatment.
Importantly, as brain tumour care is our passion you will always be our patient and we will keep in close communication with you throughout the post-operative period.
