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  • Doctors at Fortis Hospital Shalimar Bagh performed computer guided surgery to remove the largest recorded ‘space occupying lesion’ from the brain of a 33-year-old patient

    Published on October 12, 2020

    New Delhi: Doctors at Fortis Hospital Shalimar Bagh recently performed a minimally invasive, computer guided brain surgery on a 33-year-old patient. The patient had a mass (space occupying lesion) in the center of her brain, which was causing minor hemorrhages repeatedly. Performing surgery was extremely risky and despite being fraught with potential complications, the surgery was successfully completed by Dr. Sonal Gupta, Director and Head, Neurosurgery, Fortis Hospital Shalimar Bagh, and her team of doctors in a span of 5 hours.

    The patient presented with reduced mobility on the left side of her body. She had been suffering from repeated headaches and was feeling increasingly weak. An MRI revealed the presence of a mass in the center of the brain. Further medical evaluation revealed that the patient’s ‘headaches’ were actually small hemorrhages. Each time the patient hemorrhaged, the mass grew slightly bigger, increasing pressure in the brain and damaging the surrounding brain tissue. The location of the mass made it risky to operate, as it left an eloquent area of the brain vulnerable to damage which, if affected, could lead to permanent paralysis, loss of speech or vegetative/semi-comatose state. The patient and her family were exhaustively counselled about the risk associated with the surgery, post which they decided to go ahead with the same.

    Dr. Sonal Gupta, Director and Head, Neurosurgery, Fortis Hospital Shalimar Bagh said, “We adopted a minimally invasive approach so that we could minimize the risk of permanent damage.  Computer guided surgery provided us a straight trajectory to the lesion, and we were able to microscopically remove the mass. This prevented deviation which was imperative since even a slight movement to the left or right could have resulted in permanent paralysis. Before the surgery, an MRI was done and the images of the same were uploaded to the computer. Through the advanced neuro navigation system, the patient’s head surface was matched with the computer MRI images. The navigation helped us decide the point of incision, the angle from which to approach the mass. The neuro navigational system acted as a GPS, are were key in allowing the surgery to be successful, especially given its complexity. The post-operative period was smooth, and the patient was discharged on 5th day (post-surgery). So far only five such cases have been reported in the world literature and this is the largest such lesion (3.8*3.6*3.4 cm) reported so far.

    The patient, Pinky Sharma said, “My family and I were very clear that we wanted to go ahead with the surgery despite all the risks. We understood that while minor bleeds were occurring now, one major bleed would result in immediate death. We trusted Dr Sonal Gupta and she counselled us in detail about the risks associated with the surgery. We knew we were in good hands. I am now much better and grateful to her and her team for all their hard work and support. They have given me a second chance at life.”

    Mr. Mahipal Singh Bhanot, Facility Director, Fortis Hospital Shalimar Bagh said, “Our endeavor is to always provide the best possible clinical care. In this case, teamwork and careful deliberation allowed our experts to arrive at the best possible treatment approach. We worked very closely with the family who was apprehensive as it was a risky surgery. We are very happy at the successful outcome of this case and our team will continue to work diligently as per global clinical protocols for the best possible results.”