Surgery technique a first in the world

THERE is a saying that “eyes are the window to the soul”. But doctors at Groote Schuur Hospital, Cape Town are taking this expression a step further and are using eyes as a pathway to reaching the most intricate parts of the brain.

Although Transorbital neuroendoscopic surgery (Tones) was pioneered at the University of Washington and later at the University of California, both universities had never used Tones to operate on the opposite side of the brain.

In a ground-breaking and the first such keyhole operation to be performed in the world, a multidisciplinary team of surgeons have used the eye socket as a corridor to reach the temporal lobe at the base of the skull to repair a lesion – a procedure which would have been very risky to perform using the traditional methods due to associated complications and the postoperative trauma to the tissue.

The team – which consisted of an ear, nose and throat (ENT) specialist, Professor Darlene Lubbe, a neurosurgeon, Professor Patrick Sample, and an ophthalmologist, Dr Hamzah Mustak – used the left eye cavity to get to the right side of the brain of Faieza Abdol of Athlone.

It is difficult to view and operate on when using other techniques.

Abdol, a 64-year-old diabetes and hypertension patient suffered from a spontaneous cerebrospinal fluid leak – a condition where part of her brain lining tore and got stuck in the bone, causing the leaking of the brain fluid. If not corrected the defect could have led to other complications such as meningitis.

Lubbe said Abdol, regarded as an “unstable” patient