7-yr-old stays awake, calm while doctors operate brain
BENGALURU: When seven-year-old Hemanth Gowda was brought in with a locally aggressive brain tumour, arising from the left temporal area, a team of Bengaluru doctors ventured into a rare kind of surgery.
The neurosurgical team headed by Dr Satish Rudrappa, director – neurosciences and neuro-anesthetic team headed by Dr Sunil Kumar, consultant – neuroanesthesiology at Sakra World Hospital performed awake craniotomy surgery on the boy. The doctors claim this is the first time that a surgery of this kind has been performed on such a young patient.
“The literature reviews have shown that the youngest recorded age for such a procedure related to brain tumours was that of an 11-year-old, making our patient, the youngest to undergo the same,” says Dr Satish Rudrappa.
The surgery involves the patient being awake during the procedure, thereby allowing the team to monitor speech and limb movements during the resection of the tumor. “The awake craniotomy in children is always a challenge due to age, neuro-anaesthetic management and co-operation from the patient to undergo long surgeries requiring constant feedback to the surgeon,” says the doctor.
The cause of brain tumours are multi-factorial, ranging from genetic mutation to environmental changes. Dr Satish credits the neuro-anaesthetic team in not prolonging the use of general anaesthetics (propofol) beyond the initial few minutes of surgical procedure for fixing the head-frame.
As a senior surgeon had performed a significant number of such surgeries for the past several years on adult patients, the same procedure was adopted for the child, informs Satish. “No other team of doctors or experts were reached out to conceptualise the surgery,” he says.
“Our patient was co-operative throughout the four-hour long procedure. He did not panic. He and his parents were ecstatic post-surgery,” he says and adds that the child had no psychological distress despite staying awake throughout the process.
Dr Satish says he has over 15 years of experience in the field and has performed more than 11,000 neurosurgical procedures. He claims to have performed over 35 awake craniotomies for various types of brain conditions.
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