Patient sings while having brain surgery by AI robot

At 2:00 p.m. on August 10, Mr. Hai (HCMC) was taken by his family to Tam Anh General Hospital in Ho Chi Minh City in a state of lethargy and weak limbs. The results of an emergency 3 Tesla MRI scan determined that Mr. Vinh had a large brain hemorrhage measuring 4 cm.

The hematoma compresses the surrounding nervous system, the area of the brain responsible for motor and language functions. Without emergency surgery, the patient faces hemiplegia, difficulty speaking, blurred vision, and even death.

patient sings while being visualized by robot image 1 — AI robot combines MRI, DTI images... clearly showing nerve fiber bundles and blood clots compressing the patient's brain. Photo: Nguyen Tram.

Emergency situation when the patient has missed the "golden" time for stroke emergency treatment, at the same time the large amount of blood clot, ruptured blood vessels continue to flow causing increasing intracranial pressure, survival indicators are getting worse. Associate Professor, Master, Doctor, CKII Chu Tan Si, Head of Neurosurgery Department, Neurology Center and doctors from many specialties consulted and decided to choose the new awake brain surgery technique with the effective support of the AI Modus V Synaptive Robot and the latest generation Neuro-Navigation AI positioning system.

Awake surgery to remove hematoma and stop bleeding will help patients escape danger quickly, and evaluate the effectiveness of surgery more easily when the patient can interact with the doctor, move, ask questions, etc. However, the difficulty and danger of awake brain surgery is many times higher than surgery under general anesthesia, the patient is ventilated and lies still, easily controlled by medication. However, due to complete anesthesia, the doctor cannot ask the patient to speak or move to directly assess the function while acting on the corresponding brain area. "In this emergency case, we decided to perform 2-in-1 awake surgery. The reason we are confident in our decision is that we have the most modern AI brain surgery robot available today and we have a high-level anesthesia and intensive care team right at the hospital. Without a top-notch local anesthetist and intensive care doctor, awake surgery cannot be performed," said Dr. Tan Si.

At 5:00 p.m. the same day, just 2 hours after the patient was admitted to the hospital, the difficult surgery began. Dr. Luu Kinh Khuong, Head of the Department of Anesthesia and Resuscitation, Tam Anh General Hospital, Ho Chi Minh City, meticulously planned a strategy to control the patient's airway, blood pressure, and neurological function. An ultrasound machine was placed on the spot to accurately identify the 4 nerve branches to the top of the head (where the surgery took place), and block anesthesia.

In particular, the drugs used in carefully calculated doses ensure that the patient is awake during surgery but does not feel pain, does not vomit, does not have epilepsy, and the body and nerves will be most stable during and after surgery. "If pain is not reduced and nerve and motor functions are not well controlled, the patient is at risk of being agitated, afraid, in pain, and restless during surgery, affecting the surgeon's operations and the risk of dangerous cerebral edema," Dr. Khuong assessed.

patient sings while being visualized by robot image 2 — Doctor Luu Kinh Khuong gives local anesthesia to a patient before surgery. Photo: Nguyen Tram.

Before the surgery, the AI application of the Modus V Synaptive Robot harmonized all images, MRI, DTI, CT, DSA data, etc. of the patient. The nerve fiber bundles and hematomas were clearly displayed on the same vivid, detailed 3D image. Doctor Chu Tan Si performed a simulated surgery on the Robot's specialized software, choosing the location to open the skull, the surgical path to approach the hematoma accurately, effectively, and safely without having to cut through the nerve conduction bundles and surrounding healthy brain tissue.

Because the entire brain and the hematoma were visible, the doctor only needed to make a 5cm incision in the scalp, expose the skull and drill open the skull cap just 3cm, then skillfully cut open the dura mater. The patient's brain was tense and pulsating weakly. Following the path established from the previous simulated surgery and the robot's close supervision with the "green, yellow, red traffic light" system warning of the correct surgical path, the doctor placed the specialized Brainpath tube precisely into the hematoma in the right cerebral hemisphere, sucking out about 40ml of blood clots and thick black blood.

While performing the surgery, Dr. Tan Si said to the patient: “I am removing the blood clot in the brain, do you feel better?”. Mr. Hai replied: “Much better, thank you doctor.”

The team continuously talked to the patient, asking him to bend his left leg, his right leg… to ensure that the related neurological functions were preserved to the maximum. Happy to have removed all the blood clot in the brain, feeling comfortable, both Dr. Chu Tan Si and Mr. Hai hummed while the team continued to patch the dura mater, replace the skull cap and suture the skin.

Just over 30 minutes from opening and closing the skull, the team of surgeons, anesthetists, nurses and patients all wanted to cheer and rejoice when Dr. Chu Tan Si announced "the surgery was successful, congratulations to Mr. Hai and thank you all".

Thirty minutes after the surgery, the patient met his relatives and called his family. Half a day later, the results of a 768-slice CT scan showed that there was no more blood clot in the brain, and the patient's movement, vision and cognition were completely normal. Mr. Hai smiled comfortably but could not help but be moved, saying: "This is the first time in my life I have entered an operating room. The doctor drilled into my skull and removed the blood clot while I was still conscious. Until now, I still think this is a dream."

patient sings while being visualized by robot image 3 — Doctor Tan Si (sitting) and his colleagues during awake brain surgery on a patient using the Modus V Synaptive Robot. Photo: Nguyen Tram.

The patient's family said that 2 days ago, Mr. Hai drank a can of beer at a party at an acquaintance's house. After that, he continued to feel dizzy, had a headache, and vomited. The next day, the symptoms did not improve, and the family suspected that he had a stroke, so they asked him to go to the hospital immediately. However, at the first hospital Mr. Hai went to, the doctor said that it was too late to provide effective emergency treatment with traditional techniques. Mr. Hai was taken to Tam Anh General Hospital in Ho Chi Minh City because he knew about the AI Modus V Synaptive brain surgery robot.

According to Dr. Chu Tan Si, every minute after a stroke, about 2 million brain cells are destroyed. Therefore, stroke emergency treatment should be performed as soon as possible. The awake brain surgery method using the AI Modus V Synaptive robot is very effective when applied to cases of brain hemorrhage surgery due to stroke, ruptured cerebral aneurysm or surgery on the brain area responsible for motor function, especially when traditional techniques are difficult to perform effectively. At that time, the 2-in-1 awake surgery allows the doctor to remove blood clots, stop bleeding, and check the effectiveness of the surgery while simultaneously talking and asking the patient to perform movements to ensure that the corresponding nerve fiber bundles are not damaged.

“Robotic brain hemorrhage surgery brings many benefits to patients, saving lives and minimizing sequelae in cases of brain hemorrhage that were previously untreatable. We continue to plan to develop and apply this technique to brain tumor surgery, ensuring the highest efficiency and preservation of functions for patients. There will be more opportunities for patients to live a healthy life without having to go abroad or be helpless like before,” said Dr. Tan Si.

Nguyen Tram

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