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Media - Canberra Times

Canberra Times

Canberra surgeons on cutting edge

By Danielle Cronin
Health Reporter

It ranks among patients' worst fears but John James "wasn't worried" as he lay awake and unable to move while doctors performed groundbreaking surgery on his brain.

The 78-year-old retired bus driver had complete confidence in the Canberra Hospital team who saved his life by performing the delicate procedure described as a world first.

Mr James was suffering from a venous aneurysm a large blister on a major vein in the brain behind his right eye - that was threatening to rupture and was causing vision loss.

The Waramanga resident was awake as a medical team operated on his brain through a hole in his forehead.

"I couldn't move. It was the hardest part. I was pinned [down] and I could only see bits because I
couldn't move my head at all," Mr James said.

"Everybody looked after me. I was answering questions . . . yes or no. I couldn't move my head so I moved my lips."

The medical team - made up of three neurosurgeons, one plastic surgeon, two anaesthetists and four nurses - took about six hours to perform the surgery on April 26.

Mr James was conscious for about 41⁄2 hours during the critical points in the procedure.

One of the neurosurgeons, Vini Khurana, said the operation was unique because the team used high-tech equipment, employed the keyhole approach and ensured the patient was awake.

"As far as I'm aware reading the literature, this kind of thing done as a package has never been done before," he said.

Mr James, who celebrated his 78th birthday earlier this month, was experiencing blackouts and vision problems before he went to the doctor.

Dr Khurana said Mr James received a "questionable diagnosis" - that he had a brain tumour.

It was later discovered that Mr James had an aneurysm and required urgent surgery because the
blister-like growth was "very prone to haemorrhage" which could prove fatal.

Dr Khurana wanted the patient to stay awake to make sure that his eyesight was not damaged during the operation.

"We wanted to be sure in disconnecting this high-flow structure, we didn't in anyway impair his vision and so during this procedure he was awake, comfortable, talking," he said.

The team rehearsed using virtual reality software before it tackled the actual operation.

The surgeons made a 1.5cm incision in the patient's forehead and cut-off blood flow to the aneurysm, which was 13mm high with a 1mm thick wall.

"The technology we used was quite extraordinary," Dr Khurana said. "During the procedure through
my left eyepiece in the operating microscope, I could see anatomy that I was operating on and through the right eyepiece, I could see the radiology.

"In other words, it's like GPS navigation you use in the car being injected into . . . your sunglasses as
you drive."

Mr James - a father of two with three grandchildren and three great grandchildren - said he made a
"beautiful recovery" after the surgery and was discharged from hospital within a few days.

"I had to sit for an hour to make sure everything was all right," he said.

"I just came back to normal after that." Dr Khurana said Mr James had a follow-up scan six weeks after leaving hospital and there was no sign of the aneurysm.

"The bonus was that his vision improved tremendously after surgery as well, to the point where he
hardly wears glasses any more," Dr Khurana said.

Since then, Canberra Hospital surgeons had performed a similar operation on a woman who needed a brain bypass to restore blood flow.

In a few days, a young boy would remain conscious as surgeons removed an extensive tumour in a "very high price real estate in the brain".

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	Media - Canberra Times Canberra surgeons on cutting edge By Danielle Cronin Health Reporter It ranks among patients' worst fears but John James "wasn't worried" as he lay awake and unable to move while doctors performed groundbreaking surgery on his brain. The 78-year-old retired bus driver had complete confidence in the Canberra Hospital team who saved his life by performing the delicate procedure described as a world first. Mr James was suffering from a venous aneurysm a large blister on a major vein in the brain behind his right eye - that was threatening to rupture and was causing vision loss. The Waramanga resident was awake as a medical team operated on his brain through a hole in his forehead. "I couldn't move. It was the hardest part. I was pinned [down] and I could only see bits because I couldn't move my head at all," Mr James said. "Everybody looked after me. I was answering questions . . . yes or no. I couldn't move my head so I moved my lips." The medical team - made up of three neurosurgeons, one plastic surgeon, two anaesthetists and four nurses - took about six hours to perform the surgery on April 26. Mr James was conscious for about 41⁄2 hours during the critical points in the procedure. One of the neurosurgeons, Vini Khurana, said the operation was unique because the team used high-tech equipment, employed the keyhole approach and ensured the patient was awake. "As far as I'm aware reading the literature, this kind of thing done as a package has never been done before," he said. Mr James, who celebrated his 78th birthday earlier this month, was experiencing blackouts and vision problems before he went to the doctor. Dr Khurana said Mr James received a "questionable diagnosis" - that he had a brain tumour. It was later discovered that Mr James had an aneurysm and required urgent surgery because the blister-like growth was "very prone to haemorrhage" which could prove fatal. Dr Khurana wanted the patient to stay awake to make sure that his eyesight was not damaged during the operation. "We wanted to be sure in disconnecting this high-flow structure, we didn't in anyway impair his vision and so during this procedure he was awake, comfortable, talking," he said. The team rehearsed using virtual reality software before it tackled the actual operation. The surgeons made a 1.5cm incision in the patient's forehead and cut-off blood flow to the aneurysm, which was 13mm high with a 1mm thick wall. "The technology we used was quite extraordinary," Dr Khurana said. "During the procedure through my left eyepiece in the operating microscope, I could see anatomy that I was operating on and through the right eyepiece, I could see the radiology. "In other words, it's like GPS navigation you use in the car being injected into . . . your sunglasses as you drive." Mr James - a father of two with three grandchildren and three great grandchildren - said he made a "beautiful recovery" after the surgery and was discharged from hospital within a few days. "I had to sit for an hour to make sure everything was all right," he said. "I just came back to normal after that." Dr Khurana said Mr James had a follow-up scan six weeks after leaving hospital and there was no sign of the aneurysm. "The bonus was that his vision improved tremendously after surgery as well, to the point where he hardly wears glasses any more," Dr Khurana said. Since then, Canberra Hospital surgeons had performed a similar operation on a woman who needed a brain bypass to restore blood flow. In a few days, a young boy would remain conscious as surgeons removed an extensive tumour in a "very high price real estate in the brain". < Back Return to Home Page