This procedure, performed under general anesthesia, creates an opening through the skull for brain tumor removal. The surgery usually requires between two to five hours to complete. The length of surgery depends on the type and size of the tumor.
In preparation for the procedure, the patient is prepped and anesthesia is administered. The patient's head is secured to prevent movement.
Electrodes may be placed on the patient's face so the surgeon can monitor the health of the sensitive facial and other cranial nerves. These nerves are sensitive to manipulation; monitoring can be crucial to prevent nerve damage.
As the procedure begins, the surgeon creates a long, arched incision in the scalp. This tissue is folded back to expose the skull.
The surgeon creates one or more small holes in the skull. The surgeon cuts the skull between these holes to free a section of bone. This section, called a skull flap, is removed and stored. The surgeon carefully opens the thin membrane that covers the brain, called the dura.
The surgeon may insert soft, flexible retractors to hold healthy brain tissue aside. This exposes the tumor and protects surrounding tissue. The surgeon carefully removes the tumor from the brain. The surgeon may choose from a variety of instruments for the removal. The tumor may be removed with a scalpel, a suction device, an electrocautery device or other instrument.
When the removal is complete, the surgeon closes the dura and replaces the skull flap. This section of bone is anchored to the skull with plates and screws. The surgeon may place a temporary drain in the surgical site to prevent fluid buildup. The skin flap is folded back and sealed. The surgeon may use sutures, staples or a combination of both.
After the procedure, the patient can expect to stay in the hospital for three to five days. The patient usually will be able to get out of bed the day after surgery. During recovery, the patient's mental and physical status are tested, and therapy is administered if needed. Full recovery usually takes several weeks, but can take up to two months. The patient may feel fatigued during this time.