Yesterday the first operation was performed on an awake patient in the Neurosurgery operating room of theHospital of the Sea of Naples.
The team coordinated by the chief neurosurgeon Giuseppe Catapano performed the operation on a 25-year-old patient who is completing his studies in management engineering and who underwent delicate brain surgery.
During the whole operation he was perfectly awake, he collaborated with the psychologists and in the end thanks to this technique he did not report any kind of deficit: during the operation there was an improvement in the memory functions that were minimally compromised in the preoperative evaluations.
"The patient - explains Catapano - is well, today he got out of bed and we expect to discharge him very soon. We can therefore state with particular satisfaction that with this achievement we have certainly completed the neurosurgical healthcare offer at the Ospedale del Mare, so that, to date, there is no need for patients to face long and expensive long-distance travel in order to access the most appropriate care".
Catapano explains that for over a year, "under the constant pressure of the general director of the ASL Napoli 1 Ciro Verdoliva we have worked to build a team prepared to face neurosurgical interventions on awake patients. The team, made up of neurosurgeons, anesthetists, psychologists, neurophysiology technicians and nurses, thanks to a very close collaboration with colleagues from the Istituto Casa Sollievo della Sofferenza in San Giovanni Rotondo, experts in this method, has finally become operational".
The surgery was planned to choose the safest way to access the pathology with the least risk for adjacent anatomical structures. To preserve brain functions, a fundamental role is the routine use of intraoperative monitoring, but there are more complex functions such as speech, mathematical calculation ability, abstract reasoning ability, which can only be checked on an awake patient whose complex brain functions are constantly assessed by the team during the surgery, by submitting a series of questions.
The team of trained clinical psychologists assists the surgeon in selecting the patient, because not everyone can face this type of surgery, and subjects him in the days before to a series of neurocognitive evaluations with specific tests and prepares him on a psychological level to face the surgery, prefiguring the surgical scenario and training him to respond to the stimuli during the surgery.
Psychologists will follow the patient in the days and weeks after the operation to evaluate the actual impact of the operation on higher cognitive functions. A fundamental role in the team is played by anesthetists who are able to sedate the patient during some phases of the operation, without depressing the respiratory capacity and making the patient quickly awake and fully cooperative during the crucial phases of the operation.
The team coordinated by neurosurgeon Catapano, was made up of neurosurgeon Alessandro Villa, already an expert in these operations in France, with anesthetist Ciro Fittipaldi and neuroanesthetist Alessandra Candiello, psychologists Massimiliano Scarpelli, Teresa Serrapica and Annarita di Somma, nurses Biagio Cassese, Andrea Sambiase and Candida Sorrentino and neurophysiology technician Marco Iannicelli.
The group also availed itself of the collaboration in the operating room of the San Giovanni Rotondo team consisting of doctors Alfredo del Gaudio, Vincenzo Marchello and Grazia D'Onofrio.
Article published on 22 December 2022 - 20:00
