Neurosurgery Camp, Part 3: Wake Up! I’m Working on Your Brain!

May 29, 2015
Gathering Around Surgery
Many surgeons, nurses and students gather to observe Uganda's first awake craniotomy

By Diana Harvey, Associate Director of Communications and Marketing

This post is the third of a three-part series about the bi-annual neurosurgery camp at Mulago Hospital.

While I was visiting Mulago Hospital in Kampala, Uganda, along with Duke neurosurgeon and professor of global health Michael Haglund and a team of more than a dozen physicians, nurses and students, I witnessed an incredible first for Uganda: the country’s first awake craniotomy.

More than a dozen Ugandan colleagues crowded into Operating Room #7 as Haglund performed this delicate procedure to remove as much of a brain tumor as possible without damaging unaffected parts of the brain that govern motor function.

After the patient was fully sedated and a portion of the patient’s scalp was sliced open and folded aside, Haglund used a drill to cut a two-inch square-shaped segment of the patient’s skull. With the skull segment removed and the brain exposed, he then located the tumor and instructed the nurse anesthetists to begin reducing the amount of anesthesia so the patient would slowly awaken. 

The patient was from Kenya and spoke Swahili, so a translator (also Mulago’s equipment technician) was brought in to sit on a stool near the operating table and deliver instructions to the patient.

Once the patient was awake, Haglund used his instruments to probe around the patient’s brain tumor, all while asking him to move his arms, squeeze the translator’s hand, and wiggle his toes. 

Haglund was able to remove most of the patient’s tumor while preserving the patient’s motor functions.

While this was a first in Uganda—and of course, a first for me!—awake craniotomies are done routinely in the U.S.; according to Haglund, Duke neurosurgeons perform at least two of them each week.

Read the other posts in the series: