AIIMS doctors devise novel minimal invasive surgical technique for resistant epilepsy
A new minimally invasive surgical technique for treating a severe form of epilepsy, especially in children, has been devised by doctors at AIIMS.
Developed by Dr P Sarat Chandra, Professor of Neurosurgery at All India Institute Of Medical Sciences (AIIMS), Delhi, it has been published in reputed journals and presented at multiple international and national meetings.
Hemispherotomy is a very complex surgical procedure, which involves a large cranial incision, followed by a major surgery where an entire affected hemisphere is either removed or disconnected from the healthier opposite side.
However, the new technique offers a better option that is minimally invasive.
- The new technique allows the entire procedure to be performed with the use of an endoscope through an incision just of size 4X3 cm.
- The entire surgery is performed using neuronavigation, a sophisticated computer aided device.
- The brain suite is used, where MRI is performed immediately after surgery to confirm complete disconnection.
Between April 2013 and June 2014, endoscopy-assisted interhemispheric transcallosal hemispherotomy was performed in 5 children. The surgeries were performed in a dedicated operating room with intraoperative magnetic resonance imaging and neuronavigation.
The technique is usually performed on young children who find it difficult to tolerate large openings and blood loss. Furthermore, the children on whom these procedures are performed are very sick, sometimes having several hundred seizures a day. This is because a whole hemisphere is diseased and is generating severe epilepsy.
Professor BS Sharma, Head of Department of Neurosurgery, said
“Now we have over 15 cases, where this procedure has been performed with very good results. Epilepsy affects approximately ten million people in India, approximately 1 to 2 million of these people will have drug resistant epilepsy which means they will not respond to medicines”
The study describes a pilot novel technique and the feasibility of performing a minimally invasive, endoscopy-assisted hemispherotomy. The study was published recently in Neurosurgery Journal.
