Indian American Army doctor develops innovative brain surgery that avoids opening skull
New York: An Indian American Army surgeon, Major Jagatkumar Patel, has been credited with developing an innovative surgery to remove brain tumors without having to open the skull enabling quick recovery.
He and an Army neurosurgeon came up with a way of operating on a tumor at the base of the skull by going through the nose, according to the Pentagon.
“Historically, most of these surgeries were done open, which is a much more challenging procedure for the patient,” Patel said.
“Today, if a tumor is the appropriate size and location, open surgery just isn’t necessary”, he said. “Through the nose, we get the best access and the best chance of complete removal”.
Recently, Patel and Lt. Col. Charles Miller successfully carried out the innovative procedure on Marine Staff Sergeant Andy Archer, who had suffered pounding headaches for 15 years.
When he developed vision problems recently, doctors ran an MRI scan that found a tumor about the size of a golf ball, measuring 4.4 centimetres, in front of the pituitary gland and pressing against the optic nerve.
He was brought to the Walter Reed Army National Medical Centre, the premier military health facility in Bethesda.
Patel and Miller decided on the innovative, minimally invasive procedure to extract the tumor entirely through the nose.
Patel developed a plan to navigate the complex nasal anatomy and create a clear surgical pathway, the Pentagon said.
Patel used an endoscopic camera to provide high-definition, close-up of the tumor on a surgical monitor, enabling Miller to dissect and extract the tumor safely.
“If he needs to get to critical structures, I can drive the camera closer, so he has perfect visualisation”, Patel said.
Modestly, he added, “My skills in navigating the nasal approach are only useful because he (Miller) is skilled enough to completely remove the tumor once we get there”.
“It is a true team effort”, he said.
Two days after the surgery, there were no visible signs that Archer had just undergone major brain surgery, and he was already sitting up in the surgical intensive care unit. And his vision was beginning to clear.
“I don’t think anyone else in the Defense Health Agency has this kind of team performing these complex skull base surgeries,” Patel said.
“A minimally invasive approach through the nasal passages is more challenging and we are mindful that (the tumor) has to be in a certain spot to go through the nose,” he added.