Endoscopic neurosurgery: A new hope for the nation
In modern era, the surgical treatment of various neurosurgical diseases like brain and spinal cord tumors, hydrocephalus, spinal cord injury, prolapsed disc disease, stroke (hemorrhagic) is possible with great safety and less invasive way due to the tremendous improvement in using operating microscope, neuroendoscope and modern neurosurgical instruments.
Without the use of the modern neurosurgical tools, neurosurgical practice is almost invalid. Neurosurgeons in the modern world are practicing the operations either by using operating microscope or endoscope (most recent advanced neurosurgical technique) for quite a long time. And they provide very good surgical results to their patients in terms of mortality and morbidity.
In our country, the practice of modern neurosurgery is not yet well established due to the lacking of modern neurosurgical equipment and skilled neurosurgeons who are able to perform modern neurosurgery by using new techniques and equipment.
However, few neurosurgeons in the country have already started practicing modern techniques both --microscopic and endoscopic neurosurgery. They are performing routine neurosurgical operations such like- • Endoscopic brain tumor surgery (endoscopic pituitary tumor surgery, endoscopic intraventricular tumors and cysts surgery, endoscopic tumor biopsy etc) and microscopic brain tumor surgery
- Endoscopic lumbar disc (PLID or sciatica) surgery / microscopic disc (cervical, lumbar) surgery
- Endoscopic / microscopic stroke (hemorrhagic) surgery
- Endoscopic surgery for hydrocephalus (excess water in the brain) -- Endoscopic third ventriculostomy (ETV)
- Microsurgery for the spinal trauma and spinal tumors
Endoscopic brain tumor surgery is a very modern and sophisticated neurosurgical technique practiced all over the world. Recently, a neurosurgical team at Chittagong performed a few cases of endoscopic brain tumor surgery for the first time in Bangladesh with very successful outcome of the patients.
Among the brain tumor surgery they have performed endoscopic approach for pituitary adenoma, intraventricular tumor, colloid cysts of the third ventricle of the brain, and biopsy from midbrain tumor.
Prof Dr Md Zillur Rahman and Dr Aminur Rahman Azad are pioneer neurosurgeons introducing modern techniques in the country. Their team is doing sophisticated neurosurgeries in Chittagong. Prof Dr Md Zillur Rahman said, "Since I do this at a corner of the country, much people are not aware that these new practices are successfully going on in our country. Many of these patients go abroad to seek these sort of neurosurgical healthcare."
Prof Dr Zillur Rahman also informed that without the use of modern neurosurgical techniques, brain tumor surgery by the conventional approach is very difficult to perform. They need large skin incision and skull bone removal to reach the tumor site and there are every chance of injury to normal brain tissue during the operations in conventional way. Postoperatively patients need longer time to stay in the hospitals with some unacceptable morbidity and mortality.
In contrast, micro-neurosurgical and endoscopic techniques are minimally invasive. These modern techniques need very small skin incision (approximately 2 cm) or even no need for skin incision for some brain tumor like pituitary tumor. The operating time is also lesser than that of conventional way with safe removal of the tumor and no trauma to the normal brain tissue. Patients need hospital stay for a very short period (48 hours – 72 hours) and minimal or no neurological deficit results due to operation.
Prof Dr Md Zillur Rahman and Dr Aminur Rahman Azad have set up a modern neurosurgical centre by their own efforts having facilities for microscopic and endoscopic neurosurgery. "As almost all types of modern neurosurgical practice are now possible in this country with the use of these modern techniques and of course at a reasonable cost, neurosurgical patients need not go abroad for so called better treatment", opined Prof Dr Zillur Rahman.
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