In a first of its kind surgery performed in any private hospital in J&K, a team of doctors removed a large brain tumor (Clival Chordoma) without opening the skull. The procedure was carried out completely by endoscopic approach making passage through the nose right upto the base of the skull. It was carried out successfully by a team of senior Neurosurgeons, Dr Altaf Kirmani, Dr Basharat Kanth and Endoscopic Skull Base Surgeon Dr Danish Andrabi, at Shifa Hospital.
Patient (name withheld) had presented with non resolving headache and his vision had started to deteriorate. There was a tumor in his brain that was causing pressure over his optic nerves, invading the carotid arteries and compressing his brain stem. This resulted to his condition which could have lead to serious complications had the symptoms been ignored. A prompt diagnosis from the neurosurgeons, coupled with the patient’s good faith, enabled to deliver a timely treatment.
Under the expertise of renowned Neurosurgeons of the valley, Dr Kirmani and Dr Kanth and Endo Skull Base surgeon Dr Andrabi, the technique of ‘Trans Clival, Trans Sphenoidal Endoscopic Four Handed approach’ was employed. It involves two surgeons ( Neurosurgeon + Endoscopic Skull Base surgeon) working simultaneously through the nose to visualise, expose and dissect the tumor under high definition endoscopic vision. Dr Kirmani is the senior most and respected figure among the neurosurgery faculty here in Kashmir. Dr Kanth is a distinguished neurosurgeon in the valley who exclusively works to uplift the Neurosurgical services in private sector. Dr Andrabi is an ENT and Endoscopic Skull base surgeon trained from Bombay Hospital, a hub of Neuro- Skull base surgeries in India.
These surgeries are performed globally together by a team of Neuro and Skull Base surgeons and mark the new era of Neurosurgical procedures integrated with endoscopic training. With the result there is no need to open the skull from above, thereby saving the complication arising out of handling vital brain tissue, blood vessels and nerves. This method is also more efficient as a complete tumor removal is many a time possible. However, it may not be the a feasible approach for all brain tumors. The neurosurgeon, in coordination with Skull Base surgeon, decide about the desired approach keeping in mind the risk and benefit ratio in a particular case. This time the approach was purely endoscopic and most importantly the first to be performed in a private setup in J&K. This brings good news and relief to many patients who needed to travel outside valley quite often for such complex treatments.
Patient has responded well to the treatment, showing good signs of recovery. On following up with the family, they expressed their satisfaction with the effort put in by the doctors and the staff in taking care of the patient through this challenge.