Brain Tumor Surgery

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery

• Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
• Complete resection of tumor
• Removal of the tumor as much as possible to slow down its growth and improve the symptoms
• Remove the tumor in order to help other treatment
• Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
• To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery: The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:

• Extended bifrontal craniotomy
• "Eyebrow" craniotomy (supraorbital craniotomy)
• "Keyhole" craniotomy (retro-sigmoid craniotomy)
• Orbitozygomatic craniotomy
• Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:

• Laser surgery
• Photodynamic laser surgery
• Ultrasonic aspiration
• Fluorescence guided surgery (FGS)
• Electrophysiological monitoring