A milestone for neurosurgery in Sri Lanka

A team of doctors at the Anuradhapura Teaching Hospital has performed Sri Lanka’s first “Awake Craniotomy” surgical procedure, marking a historic milestone.

Awake Craniotomy is a technique that uses language mapping, which enables neurosurgeons to remove a brain tumor while preserving cognitive function. When it’s necessary to operate in areas close to the brain’s cognitive centers, such as language, the only way to test cognition is for the patient to be awake and to be able to communicate during the procedure. The department of Neurosurgery T H Anuradhapura successfully carried out such an “awake craniotomy” recently.

“The team, led by Dr. Madhushanka Gomez (Consultant Neurosurgeon) and Dr. Rohan Paris (Consultant Neurosurgeon), performed the surgery on December 1 on a patient suffering from an Insular tumor of the brain,” said Dr. Nadhun Yohan Perera of the Anuradhapura Teaching Hospital.

Anesthesia was provided by the team lead by Dr. Levan Kariyawasam (Consultant Anesthetist). The patient was given deep sedation while part of the skull was being removed, and later, was woken up during the actual removal of the tumor and was asked to perform a series of tests. These tests helped to map the safest surgical margins without causing significant damage to the language, motor, and special function areas of the brain.

Intraoperative nerve monitoring throughout the surgery enabled this mapping of the motor cortex. The technique also has additional advantages compared to the conventional methods - better quality of life for the patient and quick functional recovery, which ultimately translates into decreased hospital expenses.

“The surgery was successful with no postoperative complications or neurological deficits. The patient is happy and grateful and is about to go home,” Dr. Perera said.

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