Surgery for brain tumours

Medical case consultation
#1

*Surgery for brain tumours.

Surgery is one of the main treatments for brain and spinal cord tumours. You might have an operation to:

  1. Remove the whole tumour to try to cure it

  2. Remove part of the tumour to slow its growth and help with symptoms

  3. Drain a build up of fluid on your brain (hydrocephalus)

  4. Help to give other treatments such as chemotherapy

  5. Help diagnose a brain tumour

Having brain surgery might sound like a frightening procedure, but it is quite safe. Doctors who carry out these surgeries are very skilled specialists. You can share your concerns and worries with your doctors and cancer nurse specialist. They will be able to tell you what will happen during the operation.

Brain surgery is not suitable for everyone. It’s a major operation so you need to be well overall. And some tumours grow in areas of the brain that are difficult for doctors to operate such as the brain stem.

*Who does your surgery?

A specialist team of doctors does your surgery. They are called neurosurgeons. You might have a team of neurosurgeons working on your operation. They are led by the consultant neurosurgeon.

You might have other specialists working with the team. For example, you might have an Ear, Nose and Throat (ENT) surgeon if you have a vestibular schwannoma (acoustic neuroma) or a pituitary tumour.

*There are 2 main types of brain tumour surgery. They are called

  1. Craniotomy.

  2. Neuro endoscopy.

*Craniotomy

A craniotomy is the most common type of operation for a brain tumour. You usually have a craniotomy under a general anaesthetic. This means that you will be asleep and won’t feel anything.

During a craniotomy, the neurosurgeon cuts out an area of bone from your skull. This gives an opening so that they can operate on the brain.

You have scans before the operation to help your surgeon know where the tumour is. You may also have scans during the operation. Some of these scans are loaded into a computer to give the precise position of the tumour.

*Your surgeon uses different tools to remove the tumour. They can use:

  1. A scalpel or special scissors

  2. An ultrasound to break up the tumour and then a suction device to gently remove the tumour (ultrasonic aspiration)

  3. A special microscope to look at the brain tissue so that they can see what is tumour and healthy tissue (microsurgery)

  4. A blue fluorescent light that helps the surgeon to see the edges of the tumour more clearly

After removing the tumour, your surgeon puts the bone back (this is called a flap). They secure the bone with small metal brackets and stitch the skin over it. In most cases, the hair will hide the scar.

*Neuro endoscopy

Neuro endoscopy is also called keyhole brain surgery. You might have it to remove all or part of a tumour in the fluid filled spaces of the brain (ventricles). You may also have a neuro endoscopy to remove a build up of fluid in your brain (hydrocephalus).

An endoscope is a medical instrument, made up of a long tube with a camera attached to a monitor and an eyepiece. Endoscopes can be flexible (bendy) or rigid (fixed straight).

You surgeon carefully makes a small hole into the skull. This is called a Burr hole. They then put the endoscope through the hole. The surgeon can see what is at the tip of the endoscope either through the eyepiece or on a monitor. There are tiny forceps and scissors at the end of the endoscope. They use these to remove the tumour.