Small Openings Improve Brain Surgery

Photo: Opening from less invasive surgery in brain drawn

Less invasive surgery seems ad-
vantageous for surgeon and patient;
© Loyola University Health System

Rather than removing large sections of the skull or face, Doctor Edward Duckworth is reaching the brain through much smaller openings. In certain cases, he goes through the nose to get to the brain. Less-invasive brain surgery can result in decreased pain, less blood loss and shorter hospital stays. Also, patients react less apprehensive to it, Duckworth said.

"It's not necessary to expose a large surface of the brain in order to access a small abnormality," said Duckworth, an assistant professor, neurological surgery, at Loyola University Chicago Stritch School of Medicine.

In a traditional aneurysm repair, the surgeon cuts out a piece of skull roughly three inches high and three inches wide. After repairing the aneurysm, the surgeon uses small plates and screws to reattach the skull piece. Duckworth can work with openings about one inch across. He has performed more than 50 aneurysm repairs in this way.

Duckworth also performs less-invasive brain surgeries on epilepsy patients. In this procedure, he removes a small part of the brain that is triggering seizures.

In a recent publication, Duckworth and a colleague reported results on 201 of their patients. After being followed a minimum of two years, 78 percent were free of the most disabling type of seizures. And only 1.5 percent experienced complications. Patients stayed in the hospital an average of 2.6 days. By comparison, an earlier study found that patients who underwent surgery with a larger opening stayed seven days.

In certain cases, Duckworth can reach the brain by passing instruments through the nose and cutting a one-centimeter-wide hole in the skull. A surgical instrument goes through one nostril and an endoscope through the other. An endoscope is a tube with a light and a lens. It enables the surgeon to see tissue. Using this technique, Duckworth can remove certain tumors located in the pituitary gland or at the base of the skull.; Source: Loyola University Health System