Here is my first podcast of brain surgery. Sorry about part of the video being black&white - there is some problem with the OR camera. The parts filmed under the operating microscope are in color, though. This is a resection of a glioblastoma multiforme, a very malignant, aggressive brain tumor. The aim of such an operation is to remove as much of the tumor as is safely possible, in order to maximize the benefit the patient gets from post-op radiation therapy. Unfortunately, the prognosis with a glioblastoma is dismal. However, with optimal surgery followed by radiation therapy and chemotherapy, we can prolong life and increase life quality. In this video, you’ll see the initial approach, first the skin is incised, then the muscle is retracted to reveal the bone. The bone flap is removed (this is called craniotomy), after which the dura mater is opened to reveal the surface of the brain. Then, the arachnoid (cobweb) membrane is dissected and the brain is entered through a sulcus (groove). The tumor is removed under the microscope, and the layers are then closed in reverse order.
Below you can see an MRI image of the tumor. The tumor is the white mass in the middle of the image. It is located frontally, with the bulk of the tumor inside the lateral ventricles, which contain cerebrospinal fluid.
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