Making the best use of expertise

Awake surgery on brain, first in a government hospital, is performed at KGH

January 17, 2015 12:00 am | Updated 08:31 am IST

The more than 150-year-old government institution, King George Hospital here, has recorded a couple of rare surgeries, one of it being the first in a government hospital.

Most complicated and advanced surgeries are being performed in the hospital free of cost thanks to its expertise and the modern equipment procured recently, says M. Madhusudhana Babu, superintendent of the hospital.

An awake craniotomy, meaning an open surgery on brain with the patient totally awake and not feeling pain as he or she is kept under analgesia to control the pain, has been performed. This is the first of its kind in a government hospital in Andhra Pradesh, according to Dr. Madhusudhana Babu. The awake surgery is performed in the cases where the area of the brain in which the surgery has to be performed is very delicate and any damage to it will make the patient paralytic for life or lose his or her speech.

The impact of damage to the brain tissues cannot be gauzed if anaesthesia is given to the patient because any difference in speech or limbs losing their function cannot be known as he or she will be unconscious. Hence the patient is put under analgesia so that he or she will not feel the pain of surgery but able to speak and move limbs so that the surgeons can understand that the areas of brain that control these functions are not damaged as the surgery to rectify other parts of the brain continued.

The surgery has been performed on a 30-year-old Appa Rao of Anakapalle who has cancer of brain in a very delicate area of the right side of the brain, surrounded by parts of brain that control movement of limbs.

Neuro-anaesthetists Murali Krishna and Annapurna Sharma, Ch. Srinivas and Satish have taken care of the important aspect of keeping the patient conscious but not feeling the pain.

Patient’s speech and limb functioning have been monitored by talking to him and making him squeeze a ball. The surgery, done under NTR Vaidya Seva scheme, would have cost Rs. 2 lakh in a corporate hospital. A few days later plastic surgeons, led by HoD of plastic surgery P.V. Sudhakar, conducted a 14-hour marathon surgery on a 23-year-old man, removing a part of his lower jaw affected by a tumour and reconstructed the jaw with a leg bone (fibula) through micro-vascular surgery.

Two reams worked simultaneously on the surgery. Dr. Madhusudhana Babu says the tumour detected in the patient, juvenile psammamotoid ossifying fibroma, is rarely reported in medical journals. This surgery needed a lot of skill and hard work, he says.

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