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Specialised Surgical Programmes

Dr. Ajaya N Jha
Institute of Neurosciences

Slideshow Image 1 Our Institute is dedicated to the "patient first" with a team of specialists working together, along with the best technology available today to optimize patient outcome.
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    MRI guided surgery is done with detailed preoperative planning, intraoperative realtime imaging in brain suite, colouring the tumour tissue differently from normal brain by tumor luminescence and physiological functions monitoring. This allows for removal of tumor more completely and thus reducing the tumor burden to the maximum extent. Also the removal of tumor tissue is not at expense of damaging the normal brain tissue. This improves the outcomes and quality of life.


    Deep Brain Stimulation is done by localizing a site of subthalamic nucleus by putting a stereotactic frame and MRI. The surgery involves putting in microelectrodes inside the brain and recording the activity. After deciding the site, the electrical stimulation of the brain is done and the response of the patient observed. All during this time the patient remains conscious. The electrodes are then left inside the brain at the specified.


    Endovascular Neurosurgery Surgery .


    A small percentage of people with epilepsy do not respond to even highest doses of 3 or 4 drugs, which needs evaluation to find out the cause, and also whether surgery would be of benefit. At our centre, we have an expert team that can evaluate and perform the entire range of epilepsy surgery procedures that may be required in any patient. Our facilities include EEG, video EEG, SPECT, PET, advanced MRI and Neuronavigation, including the Brain Suite.


    At times, when medications do not give relief in Parkinson's disease, surgery can be considered a good option in selected patients. The surgery preferred is Deep Brain Stimulation (DBS), in which electrodes are placed in certain special nuclei in the brain, and connected to a pacemaker placed (typically) below the left collar bone. This surgery usually results in significant benefit in all symptoms, such as tremors, stiffness and slowness of movements. Patients with Dystonias are also good candidates for surgical procedures, especially because these do not respond very favourably to medications. Apart from DBS, there are other options including other types of surgery, lesioning and also Botulinum Toxin (BoTox) injection.


    Minimally invasive spine techniques preserve the normal musculoskeletal structures as much as possible while completely addressing the disease pathology. The Minimally invasive spine surgery and Endoscopic spine surgery involves placement of operating ports (forming the operating channel) separating the muscle fibers and thus preserving their blood and nerve supply. Now with union of advanced technology and skill sets the scars have become small almost to the size of a Rupee coin, hospital stay is in days and return to normal activities in few weeks.


    The concept of Endoneurosurgical treatment of brain disorders has been made possible by advances in telescopes (endoscopes), instrumentation, real time navigational and imaging ability, development of endoscopic skill sets and fresh anatomical detailing of the endoscopic corridors and the surrounding structures.

    The Endoscopic Brain surgery programme has four components.

    1. Endoscopic Ventricular and Periventricular Surgery
    2. Endoscopic Endoportal Brain Surgery for deep seated intrinsic brain tumors
    3. Endoscopic assisted Microneurosurgery
    4. Endoscopic Skull Base Surgery

    The advantages offered by Endoneurosurgery are better visualization of normal anatomy and the disease process allowing for preservation of normal anatomical structures and completeness of removal of the disease. This translates into faster recovery of patients and lessens the morbidity and complications of the procedure, while preventing large and disfiguring scars and trauma to underlying brain tissue.
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