"World first" surgeries to remove brain tumours through eyebrows

A surgeon in Scotland has developed a way to remove brain tumours the size of apples through patients' eyebrows in what is believed to be a world-first for the procedure.

Consultant neurosurgeon Anastasios Giamouriadis of NHS Grampian has adapted an existing technique of keyhole surgery to remove tumours which leaves less scarring than regular craniotomies.

The change enables Mr Giamouradis to remove much larger tumours from the front of the brain than was previously the case, with some the size of large apples.

The new method also takes far less time to complete, meaning operating teams are less fatigued when the procedure is finally finished.

Mr Giamouradis and his team have performed the new procedure on 48 patients so far and many of them have been able to leave hospital a day later.

"I have modified and developed the technique with my team and we are operating on very large brain tumours in the front of the brain and as far back as the middle of the brain," he explained.

"That makes a significant positive impact on the patient outcome.

"With normal, extensive craniotomies, the length of the operation is usually about eight hours and patients will spend days in the hospital.

"By doing this through the keyhole approach through the eyebrow, it is more challenging technically, but it takes probably half the time - if not less.

"The patient will go home the second day and be back to normal life in most occasions within a week or two."

Doreen Adams, 75, from Rosemount, Aberdeen, underwent the new procedure last year and said she felt "wonderful" when she awoke from the anaesthetic.

She had previously experienced headaches before falling ill and undergoing a craniotomy while abroad which was unsuccessful in removing her tumour.

Ms Adams told how she saw Mr Giamouradis while she was still recovering from her first operation and how he immediately put her at ease about having more surgery.

"He is the most wonderful young man," she said. "He told me he could sort me right away. He would put anybody at ease."

Ms Adams said she felt hardly any of the usual after-effects of surgery when she came around in recovery.

"I felt great after the operation," she said. "I was left with a black eye and it took a while for it to open, but that was all."

Mr Giamouriadis said the most rewarding part of his work in coming up with the new technique is experiencing the gratitude of patients once they awake from surgery.

"Doreen hugged me when she woke up," he said. "They are fully awake straight away, they are completely compos mentis and they are already improved in recovery.

"We joke in the team that patients are more awake than anyone else by the end of the day."

Mr Giamouriadis is hopeful he can one day use virtual reality to teach other surgeons how to perform the new improved procedure.

He revealed he is working with a team at the University of Aberdeen on the project and that they are "very close" to having it ready.

"It's very challenging to train someone in real life with this operation," he explained.

"We're developing a simulation so I can train people before we do the operation in real life. That's the safest way to do it.

"We're very close to rolling it out so we can train other people."

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