LANCET-FREE NEURO-SURGERY

LANCET-FREE NEURO-SURGERY

I wish you never need it, but sometimes the knowledge may be necessary and you may contribute to your loved ones and your environment, I would like to mention a treatment method for those of you who have not heard of it before, for those who do not know.
I am sure that most of you, if you have ever had a magnifying glass in your childhood, you have probably roasted a few papers under the sun.
I will come back to this topic later.
As is known, despite the technological research and development studies in many medical and pharmaceutical sectors, humanity has not yet been able to overcome the problem called cancer as easily as the flu. Humanity is still struggling greatly to get rid of this disease, which we have to hear about from someone in our daily life. Our nature, which is prone to cancer, is inherently present in all of us, is waiting for us like a Trojan Horse waiting for an opportunity. The Trick; is to stay away from this problem as much as possible.
The fight against cancer, which can occur in different parts of the body, is eliminated or attempted to be eliminated with many different methods. However, in the advanced stages, this phenomenon called metastasis also recurs in the Brain and accelerates the process in an undesirable way. The most important step is, of course, to be aware at an early stage and to conclude the fight with victory, no matter what.
When we talk about the Brain, the situation becomes even more delicate. Because the slightest negativity that may occur in this organ, which affects our quality of life with every single cell, can turn everything upside down. Therefore, the fight against various types of diseases, which may occur in the Brain, becomes more delicate.
When we approach to the subject from the perspective of cancer/tumor, this side of the matter may require turning to more delicate, very sensitive treatment options in the fight against cancer in the brain. In terms of cancer treatment, one of the methods is, as you know, treatment with Radiation, which we hear in different ways, is more commonly known in the public language as Radiation therapy, Ray therapy. Particularly, in order to ensure that the tissue is affected by radiation as little as possible, the fractional, separated, session-by-session treatment method is one of the choices.
However, no matter what, the way radiation is given to the very sensitive brain tissue, as a result of the radiation being given not only to the diseased cell/tissue but also from a wide range of windows, causes the healthy tissues as well as the diseased tissue to be exposed to radiation and to be affected by this situation. Once saving life, on the other hand, who knows which healthy tissue is exposed to radiation, which functional disorders that will prevent the quality of life can be caused, unfortunately, it can not be predicted.
One of the most important points in terms of its application is that while it is necessary to be meticulous in order to prevent the healthy tissue in the brain from being exposed to radiation as much as possible, more important thing is that the perspective is carried out together in order to get rid of the fatal risk as soon as possible.
By removing the diseased tissue (let's say the tumor) from the body, this will either be done with open surgery or you will proceed with a method other than this option.
Think about it, during an open brain surgery, until you reach to the tumor deep inside, you will have to touch the healthy tissue you encountered before, then it will be a matter of pray to God granting healing and making things easier.
Or, many different treatment options such as radiation therapy or chemotherapy will have to be resorted to.
If radiation therapy is to be applied to a tumor, especially in the brain, how will healthy tissue be protected from this as much as possible? In this case, of course, Specialists in the field have sat down and thought about what else can be done and developed methods to serve humanity.
One of these was Lars LEKSELL (1907-1986), a Swedish Scientist, Brain Surgeon and Physicist, and he went down in history as the inventor of Radiosurgery. #1, #2
Lars LEKSELL
He developed a method that enables access to the geography of the brain, known as a Stereotactic approach, by formulating the compatibility of the Cartesian Coordinate System with the skull structure and a mechanism that allows access to any point within the skull with precise coordinate tracking.
Thus, the approach, which initially aimed to take biopsies from diseased tissue next to healthy tissue with sub-millimeter precision, as the mastery of brain geography increased, the idea of how to use this stereotactic approach in a different area, and by including radiation beams in the process, formed the "beginning story" of the path leading to Stereotactic Radiosurgery.
The basic principle here is based on the design and management of science in such a way that each millimeter cell in the skull geography, which can be accessed with a very high level of precision, will have the least possible effect on the healthy tissue next to it.
Stereotactic Radiosurgery
For this purpose, steps were taken to eliminate unwanted cells by taking advantage of the focus effect of radioactive beams in a desired 3-dimensional geography with a design that would keep the diseased tissue in the center of the patient's skull and surround it and create a "focus" at a very precise central point, and they called these procedures "Stereotactic Radiosurgery".
Even, they achieved this in 1968, also. While some of us were not yet in the world. ))
One of the pioneers of the Gamma Knife device
While performing these procedures, instead of the radiation effect on the healthy/diseased tissue from a single collimator called radiotherapy today (this technology has also been incredibly developed and its sensitivity increased in recent years), this treatment method, which was developed to gather 192 separate beam paths on a representative hemisphere of approximately 180 degrees in an absolute focus, is more accurately referred to as the surgical method, and the "Gold Standard" radiosurgery method all over the world.
If I were to summarize the overly complicated technical expressions I explained with a very simple example, let me remind you of the humor about burning paper with a magnifying glass in the second paragraph.
This radiosurgery method works in a similar way. In other words, while parallel sun rays do not affect your skin much in a short period of time, we can describe how they immediately have a scorching effect at the focal point of a magnifying glass, a 1-unit radiation beam coming from 192 different sectors, each representing 1 unit, shows the scorching effect of 192 units of beam at the focal point. This means the following. The tissue placed at the focal point of this device is eliminated in an irreversible and lethal manner. For this reason, it is not called therapy-treatment, but "radiosurgery". Just as there is no return from diseased tissue that is cut and removed with open surgery/scalpel, as a result of the procedure performed here, it is not possible to return from the tissue that is neutralized at the focal point. For this reason, absolute accuracy and precision are very, very important. Due to this delicate requirement, they have reached this sensitivity in the most perfect way possible as a result of meticulous work during the design.
Everything is actually easier to understand from the video below.
How does Gamma Knife work?
They have achieved great success by reaching an accuracy of 0.15 mm mechanically and an average accuracy of 0.3 mm radiologically. In other words, they have reached a precision of 5-6 times more mechanically, while being exposed to 2 to 20 times less radiation compared to the closest radiotherapy devices.
Therefore, as perfect as such a sensitive medical device is in itself, thanks to the coordinated and meticulous work of talented surgeons who can accurately separate diseased tissue from healthy tissue, and the radiation oncologists and physics engineers they work with, patients benefit from the incredible effect of this device and find healing.
Thus, as a result of this treatment, which is applied in only one session, without the need for fractional sessions as in other radiation therapy devices, the patient can return to his daily life, to his normal life after the operation and if he is working, he can continue his job, and he is also saved from the recovery period that can last for months after an open brain surgery. In this way, they do not stay away from their work and continue to contribute to the country's production and economy. The patient is also saved from any serious side effects such as any incision, open surgery, stitches, etc.
The radiation beam used for this treatment is the Cobalt-60 element, and because it is a very high-activity radiation, contrary to popular belief, the treatment is completed in a very short time by benefiting from its high effect during the radiosurgery procedure.
Not only for the treatment of benign and malignant tumors in the brain, but also arterio-venous-malformations, such as AVMs (vascular masses - aneurysms), are treated with this device. This device, which is used in the treatment of some diseases such as Trigeminal Neuralgia and Epilepsy, uses Cobalt-60 ray, namely Gamma ray, as radioactivity and the procedure performed is not a therapy (treatment) but essentially a surgical procedure, and just like an intervention with a scalpel (lancet), it actually uses the Gamma Ray like a scalpel (lancet); It is called Gamma Knife.
Patients who are faced with such a disease, with the negative feelings they feel at the moment of diagnosis, are unaware of many alternative treatment methods, and they accept the open surgery that is offered to them with the capabilities of the hospital they go to, and they are on the path to a difficult process for themselves.
However, if patients or their relatives who know about such alternatives have made a decision after completing their research in this direction, I am sure they will encounter a happier ending. However, it should not be forgotten that each alternative may have its pros and cons. There may even be different indications in terms of limits and dimensions that cannot be treated with the Gamma Knife system. Therefore, reaching the most accurate evaluation within the patient-doctor dialogue will always yield the most appropriate result. Therefore, in such cases, you can mention such an opportunity to your friends who are faced with a brain disease/tumor diagnosis and recommend that they consult their doctors about whether their own conditions can benefit from such a treatment opportunity.
Today, there are 13 State/Foundation and Private Hospitals in our country (TURKIYE) that provide treatment with Gamma Knife.
While sharing these lines with you on this platform, I wanted to provide a different perspective to those of you who have never heard of this subject.
We, the human being, all wish to live our lives in health, peace and tranquility.