Daijiworld Media Network – Washington

Washington, Jul 31: An Indian-American US Army surgeon has successfully helped remove a golf ball-sized brain tumour through a patient's nose using a minimally invasive endoscopic procedure, the US Department of Defence has said.

Major Jagatkumar Patel, an anterior skull base surgeon at the Walter Reed National Military Medical Center, teamed up with neurosurgeon Lt Col Charles Miller to perform the complex surgery on Marine Corps Staff Sergeant Andy Archer, who had been living with the tumour for 15 years.

According to the Department of Defence, the innovative procedure involved creating a surgical pathway through the patient's nasal cavity, eliminating the need for conventional open brain surgery.

"Today, if a tumour is the appropriate size and location, open surgery just isn't necessary. Through the nose, we get the best access and the best chance of complete removal," Patel said.

The tumour, measuring around 4.4 centimetres, was located at the base of the brain near the pituitary gland and was pressing against the patient's optic nerve.

After Patel created the access route, he used a high-definition endoscopic camera to provide close-up visualisation, allowing Miller to carefully remove the tumour using both hands.

"If he needs to get to critical structures, I can drive the camera closer, so he has perfect visualisation," Patel said.

He described the operation as a true team effort, crediting Miller's expertise in handling highly complex skull base surgeries.

In July, the surgical team successfully removed more than 99 per cent of the benign tumour. A tiny portion was deliberately left behind because it was tightly wrapped around the patient's optic nerve, and attempting complete removal carried the risk of permanent vision loss or stroke.

"You must ask, 'Is it worth giving the patient a stroke or permanently changing their perfect vision just to get that last millimetre?'" Patel said.

The surgeons reconstructed the skull base using a small tissue graft taken from the patient's leg to seal the surgical site.

Just two days after the operation, Archer was recovering well, with no visible signs of having undergone major brain surgery. His vision had already begun improving, while post-operative symptoms were limited to expected headaches and soreness in the leg from where the graft was taken.

Patel said the successful outcome demonstrates the advanced medical capabilities available within the US military healthcare system.

"Our goal is to make sure providers know this capability exists, so patients have the best options. Most patients are happy to stay in military healthcare," he said.