At the Cremona hospital, a minimally invasive surgical technique capable of removing deep brain tumors was used for the first time, exploiting the ‘pathways of the brain’, i.e. following the natural course and folds of the most complex of the organs to reach the tumor. This is the ‘Brain Path’ or transulcal surgery, the innovative operating technique particularly developed in the United States and applied in very few Italian centers.
Antonio Fioravanti, director of the Neuroscience and Neurosurgery department of the Cremona Asst, notes that the technique “is indicated for deep and difficult to reach lesions, in which traditional surgery would cause greater suffering for the brain”. That is, the cerebral sulci are exploited, i.e. the anatomical pathways that divide the bundles of white matter responsible for important functions such as movement or language. To do this, an instrument consisting of an applicator with a diameter of 13 millimeters is used, which is inserted into the cerebral sulcus, moving the neighboring portions to reach the lesion directly. A camera inserted into the instrument allows the operation to be carried out “in a precise and targeted way”, observes Fioravanti.
“The operation continues – it is possible thanks to neuronavigation, which consists of three-dimensional mapping of the lesion and the surrounding eloquent areas. The recently introduced procedure has several advantages: in addition to being minimally invasive compared to traditional open surgery, it allows the duration of the intervention and the operative and postoperative complications that characterize highly complex operations. And the postoperative hospitalization and recovery times are shorter: the patient can be discharged in a few days and quickly regain a good quality of life.”
The first patient to undergo transulcal surgery is a 60-year-old woman. Her treatment history began ten years ago with breast cancer. “Since then – he recalls – I have been undergoing check-ups and chemotherapy, but despite this they diagnosed me with brain metastases. This surgery was the only possible solution and I accepted”. The 60-year-old is currently preparing to return home from the hospital.
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