New surgery "must read material"

[TOM101]

http://www.medicalnewstoday.com/articles/191262.php

This is a surgery we might want to follow as we watch and wait for a better method of dealing with our AN's.
It cuts surgery and recovery time and less invasive.

[nancyann]

Hi Tom:  Boehene is a surgeon working alongside Dr. Patrick Byrne in the Plastic surgery division of ENT at Johns Hopkins (I had the T3 procedure done by Byrne).
I don't know that they're operating on AN's with this procedure.  If they are, then this is MAJOR news for us !!  Thanks for the info !!
Always good thoughts,  Nancy

[leapyrtwins]

Tom -

VERY interesting article; thanks for sharing it.

For some reason, though, reading it made me cringe.  I just can't imagine them going in through your eyelid - and keep in mind that I've had the "regular" AN surgery (aka a craniotomy) and a BAHA implant (hole drilled into skull; titanium rod inserted). 

But then again, to each his own.  This may be a great option for AN patients in the future.

I'm curious if patients undergoing this type of surgery have any eye "issues".  Although my eye issues are small (mostly dry eye on occasion) there are numerous AN patients who have major eye issues.  I wonder if this surgical approach would help eye issues or make them worse.

Jan

[GRACE1]

Great article.  Thanks for sharing.

Grace

[DR]

Very interesting approach.  I can't imagine being a doctor, looking at someone's eyeball and thinking "Hmmm, I think I could get into the brain MUCH easier by just going behind eye.."

It would be interesting to see a follow-up regarding the patients vision pre and post-op.

[Syl]

I, too, cringe at the thought of this. It reminds me too much of lobodomies. This is how they did them, through the eyes.

Syl

[jerseygirl]

Thanks for the article! It is very interesting.

The approach is not new. It is done just about anywhere for all kinds of tumors located at the front and center of the brain, including pituitary tumors. What surgeons did instead of that is take a big portion of the skull or go through the palate in the mouth and pushed the brain aside to get an operating view of the tumor. That was called "traditional" approach. Needless to say, the patient was just ravaged by the surgery itself. Pain was incredible, complication and side-effects were numerous. This article describes minimally invasive approach where an endoscope is inserted through an eyelid, avoiding a lot of destruction and damage. ANs are in the back and easy to access for a surgeon even in a traditional method so there has not been enough incentive for surgeons to switch primarily to an endoscope but those who do utilize an endoscope for AN resection, enter close to AN which is the back of the head. I have a feeling if minimally invasive approach for ANs will become mainstream in the future, surgeons will still enter in the back, not front.

Back in 1988, when I had my first AN surgery, I roomed with several pituitary patients. I have been over 30 days in the hospital and as bad as there were things for me, they have been even worse for pituitary. That memory was what made me choose an endoscoipic method over traditional for my second surgery in 2007 and I have not regretted it. I only wish that this method was offered in NY; it is ridiculous to travel to CA  for it!

                                        Eve

[Jim Scott]

Tom ~

Thanks for posting the link to the article.  Increasing our knowledge of potential advances in AN surgery is always welcome.  I'm not a doctor, of course, but I suspect that, due to proximity, this 'eyelid approach' is likely better suited to actual brain surgery than AN removal surgery, which is skull-based.  However, I do think that endoscopic surgery for AN removals is a real possibility to replace the traditional surgical approaches now in use.  How this all jells into a working model for future AN removal surgery remains to be seen.  We know that change often happens at a glacial pace in the medical world but I can foresee better outcomes and shorter hospital stays for AN patients in the next decade or so. 

Jim   

[jerseygirl]

Jim,

Any shorter than 2-3 days that some people get (I got that in my second surgery) would be drive-through! That would be a great development!

                       Eve

[ddaybrat]

Simplifying AN surgery and shortening recovery time is always a plus.  Any change in current procedures that reduces the ongoing problems we all face would be nothing short of a miracle.  ANs have always been considered a rare tumor, but with the availability of MRIs, their occurance is bound to increase.  It will be interesting to see what new surical advances are on the horizon.

Medicine does inprove over the years...it's just slow to do so.  My father had a corneal transplant in Denver in 1974.  At the time, he spent 2 weeks in the hospital and had to stay in Denver for a month after his release.  He had to wear a patch over his eye and could not drive for 6 months.  Over the years, he had several more corneal transplants...each considerably simpler than the last. He had his last one in 2000 in his doctor's office in a small town in Nebraska.  He went home immediately afterward. 

Wouldn't it be wonderful if the future held the same sort of promise for AN patients?