By Jonathan A. Engh, MD, FAANS.

Brain surgery is essential, and even life-saving, to the care of many patients with brain tumors or other brain conditions. However, it is not without substantial risk. One of the central principles of medicine is “primum non nocere,” or “first do no harm.” It’s a reminder that our interventions for disease may cause injury to a patient and that we must avoid injury whenever possible.

Few interventions in medicine are more potentially dangerous than brain surgery. Stroke, hemorrhage and infection are just a few of the potentially devastating complications that can harm a patient or even lead to death. At Lexington Medical Center, we use many specialized techniques, not widely used at most medical centers, to reduce the risk of brain injury from tumor surgery.

Awake craniotomy is a specialized method of brain tumor surgery in which the patient remains awake and alert during surgery. While being kept comfortable, the patient can talk, move an extremity of interest, or name objects on a screen. This allows the neurosurgeon to track the patient’s motor function and speech in real time during the operation.

It is critical that the entire operating room team be specially trained in this technique in order for it to be successful. Otherwise, the patient can be more prone to problems like breathing complications or seizures in the operating room. Lexington Medical Center has a dedicated team that specializes in awake craniotomy for brain tumors. Using this technique allows us to work in functional regions of the brain while keeping track of the patient’s neurologic state. As a result, we can remove brain tumors that would otherwise not be safely removable.

Minimally invasive port surgery is another specialized technique utilized to prevent injury in the operating room at Lexington Medical Center. Using a small, cylinder-shaped retractor, the neurosurgeon can access deep brain regions with less disruption to the surrounding brain tissue. With this technique, patients with deep brain tumors and tumors in the fluid system of the brain (intraventricular tumors) can have successful surgery and achieve relief of their symptoms while minimizing the risk of being injured during their operation.

Learn more about the Lexington Medical Center Brain Tumor Program.