Photograph: Pixabay.comKey Points Indian-American US Army surgeon helped remove a golf ball-sized brain tumour through the patient's nose.
The minimally invasive procedure removed more than 99% of the benign tumour without opening the skull.
An Indian-American US Army surgeon in an innovative procedure removed a golf ball-sized tumour developed at the base of the brain by sending an endoscopic device through the patient's nose.
Once the pathway was clear, Patel used an endoscopic camera to provide high-definition, close-up visualisation on a surgical monitor.
Prioritising the patient's health, the team decided to leave that final fraction, confident the tumour is highly unlikely to return.
Major Jagatkumar Patel along with neurosurgeon Army Lt Col Charles Miller, carried out the surgical procedure on Marine Corps Staff Sergeant Andy Archer, who lived with the tumour for 15 years.
IMAGE: Kindly note that the image has been posted for representational purposes only. Photograph: Pixabay.com
Key Points Indian-American US Army surgeon helped remove a golf ball-sized brain tumour through the patient's nose.
The minimally invasive procedure removed more than 99% of the benign tumour without opening the skull.
The patient began regaining clear vision within days and recovered without major complications.
An Indian-American US Army surgeon in an innovative procedure removed a golf ball-sized tumour developed at the base of the brain by sending an endoscopic device through the patient's nose.
Major Jagatkumar Patel, an anterior surgeon at the Walter Reed National Military Medical Centre near Washington, DC, along with neurosurgeon Army Lt Col Charles Miller, carried out the surgical procedure on Marine Corps Staff Sergeant Andy Archer, who lived with the tumour for 15 years.
A statement from the US Department of Defence said the procedure required highly synchronised collaboration between the two experts.
"Today, if a tumour is the appropriate size and location, open surgery just isn't necessary. Through the nose, we get the best access and the best chance of complete removal," Patel was quoted as saying in the statement.
Patel developed a plan to navigate the complex nasal anatomy and create a clear surgical pathway to remove the golf ball-sized tumour, measuring roughly 4.4 centimetres, sitting directly in front of his pituitary gland and pressing against his optic nerve.
Once the pathway was clear, Patel used an endoscopic camera to provide high-definition, close-up visualisation on a surgical monitor.
This allowed Miller the crucial two-handed freedom to dissect and extract the tumour safely.
"If he needs to get to critical structures, I can drive the camera closer, so he has perfect visualisation," Patel noted.
"Dr Miller takes on these complex cases when many surgeons wouldn't want to risk the complications or step out of their comfort zone. My skills in navigating the nasal approach are only useful because he is skilled enough to completely remove the tumour once we get there. Dr Miller is very well equipped to do these surgeries. It is a true team effort," Patel said.
In July, the team successfully removed more than 99 per cent of the benign mass. Still, a microscopic fraction of the tumour remained wrapped tightly behind Archer's optic nerve, which, if removed, carried major risks, the statement said.
"You must ask, 'Is it worth giving the patient a stroke or permanently changing their perfect vision just to get that last millimetre?'" Patel said.
Prioritising the patient's health, the team decided to leave that final fraction, confident the tumour is highly unlikely to return.
"The biggest thing was to get the tumour out safely," Patel said.
"A minimally invasive approach through the nasal passages is more challenging and we are mindful that [the tumour] has to be in a certain spot to go through the nose," he said.
To complete the surgery, the team performed a reconstruction of the skull base, using a small graft taken from Archer's leg to seal the area. Just two days after surgery, sitting in the surgical intensive care unit at Walter Reed, there were no visible signs that Archer had just undergone major brain surgery.
Archer's vision had already started to clear, and while he was dealing with expected post-operative headaches and leg soreness from the graft, his spirits were high.
For surgeons Miller and Patel, and the Walter Reed skull base team, Archer's remarkable outcome highlights a broader mission: ensuring military beneficiaries know that they do not need to look to the civilian sector for cutting-edge medical care.
"I don't think anyone else in the Defence Health Agency has this kind of team performing these complex skull base surgeries," Patel said.
"Our goal is to make sure providers know this capability exists, so patients have the best options. Most patients are happy to stay in military healthcare," he added.
