Surgery and glioblastoma: A French innovation

Surgery and glioblastoma: A French innovation

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Glioblastoma is a type of brain cancer that is very difficult to treat. In France it has a high incidence rate. 2700 new cases diagnosed every year. Since the cerebral zone is very fragile, any uncontrolled intervention, even a minor one, can cause irreversible and even fatal damages for the patient. Surgery is very common in the treatment of this type of cancer. 

Sometimes the removal of the tumour is not enough to completely cure a glioblastoma. However, this type of surgery is necessary. It allows surgeons and their associates to win their patients a few more years to live. A surgical procedure that has been developed and optimized for more than 20 years is currently being talked about at the University Hospital Center of Toulouse. The results published in the scientific journal Journal of Neurosurgery are very encouraging. Awake brain surgery: a more precise procedure,which is less invasive for the patient.

What is it all about?

Awake surgery is a procedure used in the surgery room to remove the tumour from the brain. This practice has been used in France since 1997 by the neurosurgery department of Toulouse University Hospital. Its particularity: the patient stays awake during the whole process. Why this choice? Being awake during the operation, the patient uses more his brain. With a set of electrical stimuli, the surgeon observes the patient's reaction and can easily identify the cognitive areas of the brain around the tumour. The operation is more targeted and not risky for the patient's life and health. 

How is it done?

After personal discussions and all the necessary pre-operative tests, the surgeon proceeds with the surgery. The surgery is carried out in three stages:

- The patient is put under general anesthesia while the surgeon opens their skull and proceeds with a series of electrical stimuli around the tumour. An image of his brain activity is taken during the series of tests.

- Guided by the results of the MRI of the patient's brain and having the tools that enable a high-precision surgery, the surgeon removes the tumour while the patient is conscious. 

- The surgeon closes the brain while the patient is back under general anesthesia.

What are the advantages? 

For science 

Every surgery performed with this method provides a better understanding of how the brain works. A very complex organ, the brain has not yet revealed all its secrets despite all the technological advances in neuroscience. It is rather sad to point this out, but in order to move forward, science needs a human guinea pig. The case of glioblastoma being quite critical, surgery becomes a “must”. Since 1997 nearly 600 patients have been operated on by awake surgery. About a hundred references for neuro science. According to the scientist Robin Baures "All this work contributes to a better understanding of the brain and helps the surgeon in his decision making and in his action". 

For the patient

Awake surgery ivolves much less risks for the patient. The procedure spares the areas that are essential to the proper functioning of the brain and the entire body. After the operation, rehabilitation sessions are reduced. Professor Franck-Emmanuel Roux says: "Awake surgery makes it easier and safer to operate on brain tumours, with the aim of preserving essential brain functions: motor, sensory, language, writing, arithmetic and orientation functions in particular. Thanks to it, we can help more patients. To identify these functions, a small electric current is sent through the brain. The patient doesn't feel it - there are no sensory fibres in the brain – it interacts during the procedure. »

In the health sector, technological progress continues to save people! It doesn't matter what part of the world we're in. Cancer, all concerned!

(Photo by Olga Guryanova on Unsplash)

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