Key-hole Brain Surgery

We take pride in being the pioneers in the field of Functional Neurosurgery in Gujarat. We are the first to introduce this modern therapeutic option in the field of neurosurgery in Gujarat.

Key-hole Brain Surgery

Dr. Chirag Solanki has been trained in this field in his alma mater, NIMHANS, the premiere world-renowned Institute of National Importance in India under the stalwarts. He also got training under Professor Tipu Aziz, the pioneer in this field in Europe and one of the first few in the world, for Deep Brain Stimulation (DBS) from John Radcliffe Hospital, Oxford, UK. There he also trained for DBS, Spinal cord stimulation and peripheral nerve stimulation under Dr. Alex Green, Dr. James Fitzgerald and Dr. Stana Bojanic. He returned from Oxford, UK to provide his expertise to the patients in this field and establish the first ever center in Gujarat.

Functional Neurosurgery is a subspecialty of neurosurgery which includes comprehensive evaluation and the care for patients with:

  • Movement disorders (Parkinson’s, Tremors, Dystonia etc.)
  • Drug Resistant Epilepsy.
  • Chronic pain syndromes (Headaches, Neuropathic pains, CRPS, Unstable angina)
  • Spasticity
  • Paraplegia (post-traumatic or any other causes)
  • Phrenic nerve palsy causing ventilator dependence
  • Urological problems like Urinary bladder incontinence
  • Peripheral arterial occlusive disease ischemia and related pain
  • Psychiatric Disorders (OCD, Major depression, Drug addiction)

Deep brain Stimulation (DBS) for Movement Disorders

Deep Brain Stimulation also in abbreviation called DBS is the most advanced treatment option for patients with movement disorders.

PARKINSON’S DISEASE

WHY PARKINSON’S PATIENTS REQUIRE DBS?

  • There are two so-called ‘honeymoon periods’ for these patients. First honeymoon period is when medicines, especially Levodopa, are started. During which patients improve significantly.
  • In more than 50% of the patients, the disease progresses after 4-5 years of treatment with medicines. And the first Honeymoon period ends soon.
  • So treatment is no longer effective or develop complications or side effects due to medication. 
  • They develop tremors which are not responsive to medications or they develop intolerance and side effects like dyskinesia (abnormal jerky movements) and short-lasting effect of drugs leading to high fluctuation of symptoms despite frequent dosage of medications.
  • This is when DBS is the only option available which gives long lasting effect and improves the quality of life like never before. It is DBS which leads to the second honeymoon in the lives of patients with Parkinson’s.

WHO SHOULD UNDERGO DBS?

Those who have

  • Tremors not responding to drugs
  • Wild fluctuations of symptoms: “best state” called “on time” after taking drug but becomes “worst” called “off time” within a short time despite frequent drug dosage.
  • Dyskinesia which are abnormal jerky movements of body especially limbs
  • Not compliant in taking frequent drug dosages

Patients who are diagnosed with Parkinson’s disease, have a medically intractable tremor or intolerance to medication side effects and do not have any significant cognitive or psychiatric problems are eligible for Deep Brain Stimulation (DBS). The team of physicians at BNA performs a thorough examination before the procedure to determine if symptoms will respond to DBS. Up to 85% of patients usually achieve a reduction in symptoms with about 50% reduction in medications.

Each neurological disorder has specific target neurons and for Parkinson’s disease, these neurons are in the subthalamic nucleus and globus pallidus. The localization of these specific target areas and precise placement of electrodes is achieved using stereotactic 3-dimensional image guidance and electrophysiological exploration techniques. The stereotactic frameless technology used in our clinic does not require patient immobilization during the procedure and therefore is more comfortable for patients.

Doniayst

Dystonia is characterized by uncontrolled movements of a limb and/or the entire body. DBS is performed as an aid in the management of chronic and drug-refractory primary dystonia, including generalized and segmental dystonia, hemidystonia, and cervical dystonia (torticollis). It is more effective in the patients with the absence of structural brain abnormalities with an expected 30 to 50% improvement in symptoms after DBS for primary generalized dystonia.

Tremor

DBS can be effective in the management of all types of tremor including essential, as well as tremor and involuntary movements associated with Parkinson’s disease and multiple sclerosis. The patients that have symptoms not adequately controlled by medications and leading to significant functional disability can be helped by DBS. About 70% of patients with essential tremor report improved activities of daily living and up to 90% reduction of contralateral limb tremor.

Epilepsy

Epilepsy is the second most common brain disorder followed by a stroke. Epileptic seizures are recurrent seizures without a reversible metabolic source that are caused by abnormal electrical activity in the brain. Seizures clinically can present as convulsive (unusual body movements) or nonconvulsive seizures. Both types usually involve a change in the level or loss of consciousness. Causes of this hyperexcitability could be genetic, congenital, tumor, traumatic or ischemic injury. Therefore, it is important to correctly diagnose and treat the underlying cause.

What is the keyhole and endoscopic brain surgery?

Endoscopic brain surgery is a minimally invasive surgical technique that uses an endoscope, a thin and flexible tube with a camera and light at the end, to access and operate on the brain.

What is the keyhole and endoscopic brain surgery?

Keyhole brain surgery, also known as minimally invasive brain surgery or endoscopic brain surgery, is a type of surgical procedure in which a small incision is made in the skull, and specialized surgical instruments are inserted through the opening to access the brain.

How is the keyhole and endoscopic brain surgery performed?

During keyhole brain surgery, the surgeon creates a small incision in the skull and inserts an endoscope, which is a long, thin tube with a camera attached to the end. The endoscope sends images of the brain to a monitor in the operating room, allowing the surgeon to see the brain without making a large incision. The surgeon then uses specialized surgical instruments, such as lasers or microscopes, to remove the abnormal tissue or repair the affected area.

What are the benefits of the keyhole and endoscopic brain surgery?

Keyhole brain surgery offers several benefits compared to traditional open brain surgery. It is less invasive, resulting in less pain, a shorter hospital stay, and faster recovery time. It also reduces the risk of complications such as bleeding, infection, and scarring. Additionally, because the incision is small, keyhole brain surgery can be performed on older adults or people with other health conditions who may not be able to tolerate more invasive procedures.

What conditions can be treated with endoscopic and keyhole brain surgery?

Endoscopic brain surgery can be used to treat a variety of conditions, including tumours, aneurysms, cysts, hydrocephalus, blood clots and some forms of epilepsy.

What is the recovery time for the keyhole and endoscopic brain surgery?

The recovery time for endoscopic brain surgery varies depending on the type and extent of the procedure. However, patients typically experience less pain, require less medication, and have a shorter hospital stay than those who undergo traditional open surgery.

Who is a candidate for the keyhole and endoscopic brain surgery?

Not all patients are candidates for endoscopic brain surgery. The decision to use this technique depends on the type, size, and location of the lesion, as well as the patient’s overall health and medical history. A neurosurgeon can determine whether endoscopic brain surgery is a suitable option for a particular patient.

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