New Delhi, August 23: Abdur Rahman Prodhani is lucky to be alive after going through an old method of brain surgery for removal of a tumour. He underwent a procedure of brain surgery called Awake-Craniotomy. This is similar to any other open brain surgery but with a slight difference — he was kept awake during the entire process.

The doctors classify this procedure as "gruesome", even though it has been practiced successfully for a very long time. Prodhani, a 33-year-old man from Saudi Arabia, came to Apollo complaining of poor vision in his right eye. He was diagnosed with a brain tumour in the motor strip, an important portion of the brain which controls all the movements on the body.

Doctors suggested the Awake-Craniotomy process as the standard craniotomy method, which uses general anaesthesia, ran the risk of disability as there is no method of monitoring brain functions during the surgery. “The doctors promised me that during the surgery I would not have the risk of disability as much as I had in the usual procedure,” said Prodhani, who was operated on July 5. During the entire procedure, he was awake and was physically examined continuously. The patient not only responded to questions during the surgery but also moved his body parts as per the instructions of the doctors. Local anaesthetics were used to cut the brain open.

“I could hear the drill cutting my skull, but since the surgery was in process, as I was told, there was no reason to panic,” he said. “During the entire procedure the patient should be mature, calm and absolutely still. The doctors should be extremely skilled and controlled in their movement,” said V P Singh, senior consultant, neurosurgery.

Another interesting thing is that even though the brain is responsible for all sensation, it itself has no pain sensitive structures and this is what makes this procedure possible.

The patient is kept awake during the surgery to probe the surrounding eloquent regions like speech, senses and movement, thus identifying them and avoiding them. In Prodhani's case, he started losing his consciousness after three hours of surgery and that's when the surgeons decided to stop the surgery. Around 60 per cent of the tumour has been removed and the rest is being removed by radiotherapy.