Goals of Brain Tumor Surgery
When it comes to brain tumor surgery, surgeons have two main goals:
- Remove as much of the tumor as possible.
- Protect important brain functions, especially those related to speech and movement.
To achieve this delicate balance, Dr. Rima Rindler, neurosurgeon with Sierra Neurosurgery Group, performs a special kind of operation called an awake craniotomy.
What is an Awake Craniotomy?
An awake craniotomy is a type of brain surgery where the patient is awake during part of the operation. This might sound scary, but it actually helps doctors ensure that they do not harm critical areas of the brain responsible for speech, movement, and other essential functions.
Why Choose an Awake Craniotomy?
Removing Brain Tumors Safely
Tumors can be located deep within the brain or near important regions such as the frontal or temporal lobes. These areas control vital functions such as speaking, moving, and thinking. During an awake craniotomy, doctors can directly interact with the patient to ensure these functions are not being affected or damaged while removing the tumor.
A Team Effort
Performing an awake craniotomy requires a team of specialists, including:
- Neurosurgeons
- Anesthesiologists
- Neuropsychologists
- Neurophysiologists
- Surgical technicians
- Nursing staff
This multidisciplinary team works together to ensure the patient’s safety and comfort throughout the surgery.
How Does an Awake Craniotomy Work?
Before Surgery
The patient is put under general anesthesia to make the initial steps of the surgery comfortable. The scalp is numbed with medication to prevent pain during the surgery. The patient is positioned comfortably with the head secured for safety. The surgeons then proceed to expose the brain and locate the tumor. “Preparing the patient to undergo this incredibly unique experience is something we take special pride in and pay special attention to, which has led to many successful operations,” confirms Dr. Rindler.
During Surgery
Once the brain is exposed, the patient is gently awakened. This is when the truly remarkable part of the surgery begins. The patient is asked to perform simple tasks, such as speaking, answering questions, or moving a hand or foot, while the neurosurgeons use tiny electrical impulses to stimulate different parts of the brain. This helps the doctors identify and avoid critical areas that control these functions.
The Patient Experience
“Overall patient feedback has been neutral to positive,” says Dr. Rindler. “Everyone is, understandably, nervous before surgery. We make sure that the patient is positioned comfortably and is not feeling any pain. Most people report a severe dry mouth as the most difficult part of it.” Most patients remember the parts of the surgery when they are awake, but have not noted that the experience was distressing. This speaks to the careful and considerate handling by the surgical team.
Benefits of Awake Craniotomies
Awake craniotomies have revolutionized brain surgery. According to Dr. Rindler, “Awake craniotomies increase the margin of safety of resecting brain tumors,” allowing for more precise surgeries. By directly interacting with the patient, surgeons can better navigate the complex landscape of the brain, minimizing the risk of damaging important functions.
Patient Stories and Feedback
Patient feedback has been generally positive. Despite initial fears, many find the experience less daunting than expected. The personalized attention and expertise of Dr. Rindler and her team play a crucial role in making patients feel cared for and secure. According to the National Institutes of Health, an awake craniotomy is well tolerated by patients.
Sierra Neurosurgery Group’s Expertise
Sierra Neurosurgery Group has been performing awake craniotomies for function mapping and placement of deep brain stimulators for movement disorders, over the last decade. The most current program for awake craniotomies for resection of intra-axial brain tumors began in the summer of 2023.
A Consistent, Multidisciplinary Approach
The goal of this new program is to develop an expert team that consistently provides high-quality care. This multidisciplinary team works together to seamlessly perform awake mapping of speech and motor areas during tumor resection, ensuring the best possible outcomes for patients.
A Brave Choice for Better Brain Surgery Outcomes
“Choosing to undergo brain surgery while awake is incredibly brave,” states Dr. Rindler. It offers the best chance to remove as much of the tumor as possible while preserving essential brain functions. Dr. Rindler and the team at Sierra Neurosurgery Group are dedicated to making this unique experience as positive and successful as possible.
If you or a loved one needs brain surgery or a second opinion, you can ask your doctor for a referral to Sierra Neurosurgery Group at (775) 323-2080.