Nigeria boasts stealth technology to guide brain surgery

Before Vanessa turned nine months, her mother noticed something going wrong. Her head was growing larger, far larger than her twin sister’s.  The diagnosis brought another shock: a cancer sat right in the middle of her brain.  The dilemma was how surgeons could cut into the brain of a nine-month-old without doing irreparable harm. They […]

Before Vanessa turned nine months, her mother noticed something going wrong. Her head was growing larger, far larger than her twin sister’s. 

The diagnosis brought another shock: a cancer sat right in the middle of her brain. 

The dilemma was how surgeons could cut into the brain of a nine-month-old without doing irreparable harm. They needed a neuronavigation system, a sort of GPS into her brain.

Ten “buttons” were stuck to different positions on her skull. Their task was to map the distance of the tumour from her skull and its exact position in her brain.

Real-time scans of the map appeared on screens, and the surgeons began work. They made a small incision in Vanessa’s head, took out a bit of bone, and they were inside her head. 

The scans guided the probing. Right on the mark, the computers stayed silent. Off the mark, they bleeped alert. This wasn’t Gurgaon, India. This was Abuja, Nigeria.

The nine-month-old is among a handful of patients to have undergone complex precision surgeries with a neuronavigation system looking inside their head and guiding surgeon’s scalpels.

“You are not going to beat around the bush once you get into somebody’s head,”  Dr Charles Ugwuanyi, neurosurgeon at Wellington Clinics, Abuja, said. 

He operated on Vanessa, one of few patients to have gone through the hospital’s two-month-old neuronavigation system.

“There are so many teaching hospitals with neurosurgeons operating every day. But the thing is, what you are doing is, it in line with contemporary standards?

“Without the equipment when you get into someone’s brain, everywhere is looking the same. You dissect here, it isn’t there; you dissect there, it isn’t there; by the time you fiddle around like that, you are inevitably damaging the brain because there is nothing guiding you,” he said.

And it isn’t just a guide around the brain. Ear-nose-and-throat, orthopaedic and spine surgeries—all surgeries where precision is required—have separate modules. The firm behind the technology insists the system used on Vanessa is the only one it has installed across West Africa.

Neuronavigation isn’t the stuff of medical dramas. It has been on the international medical scene for more than a decade, commanding the attention of patients journeying abroad for surgeries. It has only taken determination and training and money to bring it down to Nigeria,  Dr Murayo Salawu, the anaesthetist who put Vanessa under for her surgery said.

She has used the system six times, on six patients. They could have been more.

“With more awareness, people will know it can be done here instead of going abroad. Apart from it being cheaper for you, you are closer to your family,” Salawu said.

A lawyer, Longinus Eze has his mother by his side, and a tumour in his brain. The mass has affected his vision, hearing and movement. 

“His sight closed completely,” his mother Patricia said. “He can only see you and say you are black, but he can’t see beyond blurred forms. For months he couldn’t walk.”

Buttons stuck to his head have helped map the tumour. After several previous surgeries, the “GPS” have pinpointed the mass and he is ready for surgery.

Neurosurgeon Dr Victor Udekwu returned to the country for Eze’s surgery and is excited.

“When you have a young man with a brain tumour that you can help, of course. The question depends on when you get the tumour, chemotherapy, prognosis…We are going to go ahead and get the tumour out, as much of it as we can.

“There are things that show Nigeria should be a centre in the whole of Africa where we can be getting referral of patients. Nigerian patients shouldn’t be going to India when you have the skills set and Nigerians that can fly in from other countries, who are already trained to deliver these services and save the country from the scarce foreign exchange the government has been screaming [about],” he said.

Vanessa’s surgery took two hours. She was breastfeeding by evening of the same day. She was monitored for infections, dosed on antibiotics and painkillers, all the routine post-op checks that could last two weeks. Five days after her surgery, she left hospital.