In fact, so small can be in the incision and so reduced the trauma, some operations can be done under local anesthesia, says Dr Vikas Gupte, Consultant Neurosurgeon, Wockhardt Mumbai, who is one of the few doctors in India to have conducted ‘‘slipped disc surgery in the awake state’’. In some cases, such incisions can be closed by a single stitch, says Dr Gupte, a specialist in Percutaneous Endoscopic Cervical/Lumbar Discectomy. Similar is the case of the brain.

‘‘Years ago, a tumour removal involved opening up a considerable portion of the skull,’’ says Dr Rajendra Prasad, Senior Consultant, Neurosurgery and Spinal Surgery, Apollo, whose father too, had been a neurosurgeon. ‘‘Today, we can zero-in on the exact area and operate using the smallest possible incision, using only local anesthesia in some cases.’’

The process is hugely aided by ‘‘neuronavigation’’, where a CT scan is reformatted into a three-dimensional image to give the exact location of the affected area. ‘‘This is so specific that we could extract a bullet from the head of a man and in another case, accommodated the wishes of a 10-yr-old girl, who insisted on not shaving her head fully,’’ adds Prasad.

Elsewhere, doctors have confined the incision to the eyebrows, where they can be effectively concealed, says Dr Deepu Banerji, Consultant neurosurgeon, Wockhardt Hospitals, Mumbai. And some brain tumours are even being accessed and extracted through the nose in what is called ‘‘trans-nasal tumour extraction’’ in medical parlance.

... contd.