The Guardian

London, March 7:

Patients with a rare form of brain tumour are being kept awake during a lengthy operation so that they can talk to the surgeon and help ensure their speech faculties are not damaged.

The pioneering surgery is carried out under a local anaesthetic to the scalp so that patients feel no pain. They remain fully conscious and communicative while the doctor removes tumours that have become embedded deep within the brain.

The surgery, known as awake craniotomy, has been performed occasionally on epileptic patients but very rarely on those with brain tumours. Now the technique is being used on such patients as they might otherwise have a much shorter lifespan.

A BBC television documentary (to be screened today) shows 30-year-old Adrian Theobald being diagnosed with a benign tumour that would nevertheless kill him through its growth without surgery.

His neurosurgeon, Henry Marsh, is the only doctor in Britain to perform the procedure for patients with these tumours. When Marsh first diagnosed the condition he had to warn Theobald that there was a risk in cutting so deep into the brain to remove as much of the growth as possible: the parts of the brain which govern speech, language or personality might be affected.

The documentary followed the fortunes of Theobald, who survived the procedure despite falling into a coma after the surgery. During the four-hour operation he had the top of his skull removed and Marsh then started to remove as much as possible of the 6cm-long growth because it was pushing dangerously into the left frontal lobe near the speech area of his brain.

As parts of the tumour were removed they were given to pathologist Peter Wilkins who carried out an immediate biopsy to ensure that it was tumour rather than healthy brain tissue which was being excised.