NEUROSURGICAL ONCOLOGY
Neurosurgery is a highly specialized niche that plays an integral role in the
treatment of brain tumours. The brain is the complex and delicate organ in
the human body; planning brain surgery demands that we address the challenge
of quality of life post the procedure. Maximum Safe Debulking is a process
that refers to the maximum size of the abnormal tissue that can be
surgically removed without compromising critical brain functions. Often
neurosurgery is used as the first line to defense to reduce the size of the
tumour to manageable sizes; post this, other forms of treatments are used to
eradicate it.
TYPES OF SURGERIES
Tumours at difficult and deeper locations of the brain are removed
effectively and safely using cutting edge technology and expertise, thereby
facilitating adjuvant therapy if needed. This includes the tumours of the
Thalamus, Hypothalamus, pineal region and the brain stem.
Minimally Invasive craniotomy
Keyhole surgeries to remove the tumours at the depth with an eyebrow incision
are performed routinely achieving an excellent cosmetic outcome and
minimizing the hospital stay.
Awake craniotomy
Our team at APCC has the expertise in performing the maximum number of awake
craniotomies in the country, minimizing the risk of paralysis during the
surgeries in the key areas of the brain.
Spine tumours both inside and outside the spinal cord are handled efficiently
with spine specific D wave monitoring which is the gold standard along with
dorsal column and sphincter monitoring to prevent incontinence post
operatively. Spinal neuronavigation with integrated Intra op digital C arm
helps in localizing and removing spine tumours with smaller incisions.
Childhood Brain and spine tumours
The higher incidence of malignant tumours and the smaller blood volume with
the anesthetic challenges associated make the Scylla and Charybdis of
paediatric neuro-oncology. APCC is well equipped to make this difficult
journey as safe as possible for the affected child.
ADVANCED SKULL BASE SURGERY
Large tumours of the skull base require a multi-disciplinary approach with a
combination of endoscopic and microsurgical excision of tumours. Our
neurooncology surgeons and the Head and neck team work together to achieve
maximal tumour clearance.
We also perform high flow vascular bypass to radically eliminate skull base
tumours.
Operating Microscope - ZEISS KINEVO 900
The most advanced system available worldwide, has redefined surgical
visualization for advanced surgical certainty. With its unique Robotic
visualization system and the blend of optical and digital modalities, Kinevo
provides the neurosurgeons, the much-needed armamentarium in their fight
against CNS cancers.
StealthStation S 8 Neuronavigation system
Allows us to precisely locate anatomic structures in either open or
percutaneous procedures. The most advanced version worldwide, S8
StealthStation, is a combination of hardware, software and tracking
algorithms, image data merging and specialized equipment to help the
neurosurgeon map his way along this difficult terrain during surgery.
CUSA - SonopetCavitron Ultrasonic Surgical Aspirator
Uses ultrasonic technology to help to remove tumours. The tips vibrate in
very high frequency in the range of more than 50 GHz and create an
environment of negative pressure in the targeted tissue. The cells expand
under the increasing pressure until they burst. This process selectively
spares healthy tissue, blood vessels and nerves while cavitating and
selectively sucking out the tumour tissue.
IONM
Intraoperative Neuromonitoring makes use of advances in electrophysiology to
minimize the risk of injury to neural pathways during neurosurgical
procedures of the brain and spine - SSEP, MEP, EEG, EMG, BAEP, VEP, mapping
of the motor and sensory cortex, language areas and subcortical tracts
mapping have made surgery much safer to protect vital nerves of the body.
Tumour Fluorescence in Brain tumour surgery
The advanced Kinevo operating microscope facilitates the use of fluorescent
dyes (5- ALA & Sodium fluorescence) during surgery for brain tumours to
identify and distinguish tumour cells from normal cells in the Brain. This
facilitates the removal of tumours selectively and preserves the normal
nerve tissues surrounding the brain.