The first step in the treatment of many benign and malignant tumors - operation. Often it is possible to remove the tumor without the risk of damage to the nervous system.
Assuta - private network of clinics in Israel. Office in Tel Aviv - the largest surgical center with an area of 970 thousand square meters.. Neurosurgical department is equipped with modern medical equipment from leading manufacturers. Every year in the Assuta held about 90 thousand. Operations. In addition to the high level of medical care that meets international standards (certified JCI), the clinic provides quality service. If you need help, please send a request through the request form or call +972 (3) 3741626.
Indications and contraindications for surgery to remove a brain tumor in Israel
This surgery is recommended in the following cases:
- It is possible to remove or destroy the maximum amount of tumor.
- Tissue sample is needed for accurate diagnosis of a neoplasm or genomic testing.
- It requires resect part of the tumor, to relieve intracranial pressure or reduce neoplasm value for further treatment with radiotherapy or chemotherapy.
- Direct access is needed to introduce the implants for cytostatic drugs, radiation therapy or genetic treatment of malignant tumors.
- Eliminate seizures because of brain tumors that are difficult to control.
Radiosurgery - a kind of intensive radiotherapy delivered to the tumor. It is used instead of - or in addition to the normal operation. Radiosurgery - it's not surgery, literally, as the skull is not opened. Sometimes this method offers, as it has similar benefits and carries less risk and discomfort than traditional surgery.
When surgery is not recommended for a brain tumor?
When considering surgery the doctor will consider the following factors:
- Location of the tumor. According to its localization determined operable or not. Resectable tumor is usually solitary, and can be removed with minimal risk of brain damage. Sometimes surgery is not possible, because the tumor is located deep inside the brain, and resection carries a high risk of organ damage. For example, the localization can be brainstem or thalamus. Neoplasm is also risky to remove if it is located next to the area that controls speech, movement, vision or other important functions. The latest imaging technology, planning, navigational tools in Assuta used during brain surgery to create an accurate picture of the location and size of the tumor. These capabilities significantly increased the accuracy of diagnosis and allow neurosurgeons to safely remove previously inoperable tumors.
- Diagnosis and size of the tumor. If a benign tumor does not cause an increase in intracranial pressure (due to the small size), or surgery can cause problems because of the proximity to vital areas, to surgical treatment can not handle or postpone it for a while.
- The number of tumors. The presence of multiple tumors creates additional problems for safe resection.
- Boundaries or edges of the tumor. Sometimes that is difficult to identify the boundaries of tumors and, accordingly, it is difficult to remove it completely.
- General state of health. Will the overall health of the body to withstand the strain of surgery? For example, if brain tumors are malignant metastatic focus in another organism.
- Neurological status. Doctors find out if whether the increased intracranial pressure symptoms. Are there any signs of neurological damage caused by the tumor. If - yes, before the operation is assessed neurological status.
- Previous surgeries. If the operations have occurred earlier, it takes time for recovery.
- Other treatment options. In the case where there is a possibility that another method of therapy is able to provide equal or better results at a similar or lower risk, this is taken into account when planning the treatment of a doctor.
Preparation for surgery to remove a brain tumor in Israel
After the surgery will be approved by the physician, the patient will receive instructions for the passage of the necessary diagnostics. Depending on the choice of the operation, the patient's age, the doctor will prescribe blood tests and chest X-ray to check your overall health. They are made in a few days before surgery.
To determine the exact location of the tumor designate additional imaging tests. It can be:
- MRS (magnetic resonance spectroscopy).
functional scan where you need to speak, read, write or move my arms or legs can be assigned. For example, a functional MRI (fMRI). These tests determine the critical parts of the brain that controls speech and movement centers.
Types of operations to remove a brain tumor in Israel
The most common types of surgical procedures are outlined below.
This is a procedure in which a sample of the tumor is removed. A pathologist then examines it by microscope to determine the exact type of fabric. It can also be carried out analysis of the chromosomes and other molecular characteristics. A biopsy may be performed as a single procedure or as part of surgery to remove the tumor.
There are three types of inspection:
- Fine-needle biopsy. The doctor performs a small incision, a hole is drilled in the skull, a hollow needle is inserted into the tumor. A small amount of tissue remains in the hollow needle portion for further examination.
- Stereotactic biopsy. It is performed similarly to the previously described procedure, but using computer guidance system with a view to more accurately determine the location of tumors.
- Open biopsy. A tissue sample taken during surgery.
Craniotomy (craniotomy) - surgery to remove a brain tumor in Israel
Craniotomy - the most common type of surgery to remove a brain tumor in Israel. "Srani" - means the skull, "otomy" - cut. This procedure involves the following steps:
- With the head shave hair.
- Perform the cut.
- Remove part of the skull with the help of special tools.
- Neurosurgeon resected maximum tumor volume.
- The extracted portion of the skull is put in place, the scalp is closed by sutures.
The operation is performed under general anesthesia and local anesthetics are used. The brain itself does not feel pain, so surgery can be performed in the waking state, during the so-called Awake craniotomy, to minimize the risk of the procedure.
Kranioektomiya - an operation to remove a brain tumor
Kranioektomiya like a craniotomy, except that the skull bone removal not return to place. Neurosurgeon can perform kraniektomiyu if he expects that after the operation there edema or skull bones can not be reused. In the event that you can apply, the bone may be set at a later date, when it will not cause additional pressure. Team doctors inform the patient as to provide protection in the absence of the missing bones.
The term "debulk" means reduction of tumor size by removing the greatest possible volume. However, he does not explain how it will remove most of the tumors, and what kind of surgery is chosen.
Partial tumor removal
This operation means that the neurosurgeon removes only a portion of tumors due to the risk of neurological damage. The remaining segment require further treatment - radiotherapy or chemotherapy. When partial removal of a tendency of further growth of the tumor. How long it takes depends on the type and volume of tumors.
Total resection - surgery to remove a brain tumor
The neurosurgeon removes the tumor entirely. the operation doctors are often called "total resection." MRI images taken after surgery did not show the presence of tumors. Nevertheless, there remains the probability the abnormal cells remain after complete removal. They are able to grow again, but it is too small to be seen by the human eye, and even with the help of a surgical microscope. After the operation, the neurosurgeon to say based on the type of neoplasm, whether its growth will resume. If additional therapy is recommended a positive response to remove the remaining cells.
Surgery for tumors of the brain - the installation of the shunt
Pressure within the skull increases in the following cases:
- there is excess fluid in the brain;
- tumor blocks the path of the fluid.
To remove excess liquid using the drainage system, which is called grafting. Shunt - a narrow, flexible tube that moves fluid from the brain to another part of the body. One end is placed in one of four cavities or ventricles of the brain where the cerebrospinal fluid is circulated. Small attached to the shunt valve, it controls the flow rate and allows to drain cerebrospinal fluid down. The handset runs under the skin, goes down the neck into the abdominal cavity or into the right atrium of the heart (less). In any case, the shunt fluid away from the brain and is absorbed by the body. Through it also leave small pieces of tissue and tumor cells, wandering in the cerebrospinal fluid. To secure the shunt surgeon performs a small incision in the neck, chest and / or abdomen.
The shunt can be temporary or permanent. Sometimes one end of the tube is placed in a brain ventricle and connects with the outer bag outside the body. This procedure is called a ventriculostomy, it is only temporary.
After installation of the shunt the majority of patients, especially children, experience a significant improvement in a few days or weeks. However, the required measures to maintain the normal state of the device, it is connected with the following possible reasons:
- Lock shunt.
- The gap shunt.
- The need for extension of the shunt due to the growth of the child.
In these cases need additional surgical procedure.
The shunt can not be used at high pressure in the brain. pressure peaks can move it up or down in the direction of the spine. In such cases, doctors use other methods that reduce the pressure before installing the shunt.
Ommaya reservoir - operation at brain tumors
Ommaya reservoir - a small container, implanted surgically under the skin of the head, connected to a tube. The latter is placed in a brain ventricle, where the liquor is circulated, or a fluid-filled cyst. The reservoir is used for the following purposes:
- To deliver chemotherapy drugs directly into the brain or cerebrospinal fluid, without resorting to a lumbar puncture.
- Take a sample of cerebrospinal fluid from the reservoir to examine for the presence of abnormal cells.
- Remove the fluid inside the cyst in its accumulation, without resorting to surgery.
Ommaya reservoir placed in 15-20 minutes. It is mounted as a stand alone device or as part of the shunt. If the tank is no longer necessary, it is removed.
Surgery at the base of the skull
Surgery at the base of the skull - is a specialized technique used to remove the tumor in a particular area. It is a thin bony zone supporting the lower part of the brain. Located here tumors are often surrounded by nerves and blood vessels associated with processes such as sight, smell, hearing, speech, swallowing, facial movements.
This is a complex surgical intervention. It may include surrounding the brain and restore it to the bone removal without disturbing the function of the major nerves or blood vessels in this area. Surgery at the base of the skull can be very long.
Trassfenoidalnaya (transphenoidal surgery) operation to remove a brain tumor in Israel
This approach is often used in pituitary adenoma or craniopharyngioma. The term "trans" means by, "sphenoid" - a wedge-shaped bone located under the eyes and above the nose. The entry point for the neurosurgeon - through the incision under the upper lip and over the teeth directly or through a nostril.
Laser interstitial thermotherapy
In laser surgery is heated brain tumor tissue under MRI control with temperature measurement in real time. The laser probe is directed to the tumor through one or more small holes using stereotactic techniques.
Laser interstitial thermal therapy - a relatively new technique. It is referred to in some types of tumors that are difficult or impossible to access by conventional craniotomy.
Prices for an operation to remove a brain tumor
This surgical procedure - one of the toughest. In Israel, high-class specialists who can treat even severe cases. A treatment plan is developed the council of physicians. Appointment procedures will determine the cost of therapy. For more detailed information, send the documents with the diagnosis through a form on the site. Here are some quotations:
A diagnostic program:
- Consultation of the oncologist, neurosurgeon - $ 560-600
- Blood tests (coagulation, biochemistry, etc.) - from 80 $
- MRI of the brain mozga- 1470 $
The operation to remove:
- Craniotomy - 34 000 $
- Histopathological examination biopata - 1170 $
The cost of surgery is already included rehabilitation, including being in intensive care (1 day) and hospitalization (3 days).