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A tumor embedded within a woman’s cranium has been excised via keyhole surgery through her eye socket for the first time in the UK.
Ruvimbo Kaviya dealt with a meningioma located in the region beneath her brain and posterior to her eyes, which was traditionally viewed as inoperable.
Historically, removing tumors from such areas has necessitated intricate surgical procedures that involve the removal of a significant portion of the skull and displacing the brain to gain access to the cancer.
This methodology is accompanied by a heightened risk, potentially causing severe complications, including seizures.
However, it has been disclosed that surgeons from Leeds Teaching Hospitals NHS Trust successfully extracted Ms. Kaviya’s tumor through the eye socket using keyhole surgery.
Medical professionals honed their skills in this method — referred to as the endoscopic trans-orbital approach — several times initially with 3D models of Ms. Kaviya’s head and subsequently on cadavers.
She is now left with merely a small scar adjacent to her left eye.
Surgeons have begun to conduct similar operations, providing optimism to patients in the UK whose tumors were formerly deemed inoperable.
Neurosurgeon Asim Sheikh stated: ‘There has been a shift towards minimally invasive procedures over the past few years, fueled by technological advancements, innovative tools, and 3D modeling, making it feasible to conduct surgeries with reduced morbidity, resulting in quicker and improved patient recovery.’
He elaborated that traditional approaches to accessing the tumor’s location involved ‘applying pressure on a significant amount of brain tissue.’
‘Excessive pressure or retraction of the brain can lead to post-operative seizures,’ Mr. Sheikh elucidated.
‘In contrast, this method does not require us to make any contact with the brain at all.’
‘This region is challenging to access, and our approach offers a direct pathway without exerting pressure on the brain,’ he added.
His colleague Jiten Parmar, a maxillofacial surgeon, developed a technique involving a minor incision on the outer wall of the eye socket to facilitate greater access for the endoscope.
Mr. Parmar mentioned that prior to this innovative method, the surgical area was ‘difficult to reach from the exterior without removing a large portion of the skull plate,’ a process that could inflict substantial damage.
‘Utilizing the eye socket provides access to the same space and is a significantly more refined approach,’ he remarked, noting that this method disturbs fewer nerve pathways.
James Robins, a neurosurgery fellow, remarked: ‘This represents significant surgery executed with minimally invasive methods—it’s still a considerable undertaking.
‘Employing the endoscope, which measures roughly five millimeters in diameter, requires only a minimal space to gently shift the eye aside, allowing access to the rear of the eye socket while removing a small, customized piece of bone.’
From that point, the tumour can be meticulously extracted.
Ms Kaviya expressed that the tumour was inflicting intense headaches, and upon being offered the surgery, she was indifferent to the fact that this would be the first occurrence of such a procedure in the UK.
‘I experienced headaches resembling electric shocks on my face,’ she recounted.
‘I couldn’t even tolerate any contact on my facial skin, couldn’t eat, couldn’t brush my teeth; it was genuinely dreadful.’
‘I felt I had no choice but to consent, as the pain was unbearable—I didn’t even contemplate it being a first, all I desired was for it to be removed.’
Ms Kaviya, who has three children ages eight, 12, and 13, mentioned that her family was ‘cautious’ about the procedure.
‘But I assured them, “I simply have to do this—it’s either this, or it continues to grow, and perhaps I could perish. Who knows?”
‘“Every milestone has its initial experience. Thus, perhaps, this is my best opportunity to resolve it.” And indeed, it was.’
This now 40-year-old underwent the procedure in February 2024.
Although she returned home within ‘days’—quicker than anticipated—she required three months off from work, during which she coped with ‘double vision.’
Nevertheless, she is presently back caring for patients in Leeds requiring stroke rehabilitation.
Ms Kaviya stated that she has a ‘very tiny’ scar, adding, ‘If you don’t look closely, you won’t even notice it.’
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