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A team of clinicians at the Helen Joseph Hospital has just performed its pioneer brain tumor operation with patient awake.  
 ​​The procedure known as awake open craniotomy in medical terms was performed to a patient who presented with brain tumor.  This surgery is often used to treat brain tumors and epileptic seizures. ​
The operation is an advanced procedure that requires the coordination and expertise of a multidisciplinary team at a surgical, anaesthetic, nursing levels and expert contribution from the technical teams supporting the procedure. 
In this case, the lead surgeon for the procedure Dr Christos Profyris says after the assessment of the condition the best approach was to do the procedure with the patient awake. 
"Because the tumor was wrapping around some brain tracts that are responsible for language, there was a real risk that the patient would not be able to speak again. An Awake Craniotomy therefore allowed the team to talk to him and examine the patient's ability to speak while removing the tumor.''
The operation starts with the patient asleep, a local anesthetic nerve block is administered to numb all the nerves supplying the skull which allows for the patient to wake up during the surgery and not experience pain.  Once the tumor is identified a partial removal is undertaken and the patient is woken up to do language exercises such as testing for understanding, ability to read, to interpret pictures and pronounce words.
Dr Profyris says the approach used for this surgery increased the recovery rate of the patient who was discharged two days after the procedure.
''The operation was successful, the patient recovered immediately, which is partly attributed to the minimally invasive approach that we utilized.  They had no problems with speech after the operation nor any other neurological problem, the seizures that they were experiencing prior to the surgery also disappeared' 'said the elated Dr Profyris.
Helen Joseph forms part of the few public hospitals that have performed an awake craniotomy in the country and Dr Profyris said that according to his best recollection there was one awake craniotomy at Chris Hani Baragwanath Hospital last year and another one at Inkosi Albert Luthuli Central Hospital in 2018.
"To the extent of my knowledge, this was the first Awake Craniotomy in South Africa using minimally invasive principles.'' Dr Profyris confirmed.