Laser-assisted Surgical Procedure a First for Neurosurgery

Seventeen-month old Masslino Franke from Manenberg was born prematurely on 27 August 2013 and suffered extensive bleeding in his brain. 

This bleed caused the fluid in his brain to build up and form located scar tissue or membranes, otherwise known as multiloculated hydrocephalus, an incredibly difficult condition to treat.

The Paediatric Neurosurgery Unit at Red Cross War Memorial Children’s Hospital took Masslino under their wing, as the hospital is one of the few facilities in South Africa that offers advanced endoscopic treatment, where a small telescope-like device equipped with a high-resolution video camera and eye piece on the end allows the neurosurgeon to navigate and access the brain, as an option for the treatment of complicated hydrocephalus. 

The intricate procedure performed on little Masslino marks the first time that laser-assisted neuro-endoscopy has been performed in South Africa. This is an important milestone as the technique used provides the finest surgical precision available for such a complicated disease, allowing surgeons to cut through the thickened scar tissue deep within the brain. The use of the laser-assisted endoscopic technique will provide the opportunity for the surgical team to perform many more complex, minimally-invasive procedures for hydrocephalus (water on the brain) and certain types of tumours. 

The minimally-invasive, delicate surgical procedure was performed by a team of paediatric neurosurgeons, led by Dr. Llewellyn Padayachy at Red Cross War Memorial Children’s Hospital. Planning of the procedure took some time and involved input from a leading international neurosurgeon experienced in the technique. Communication between the water spaces was restored, relieving the increased pressure in the patient’s brain.

The procedure offers many benefits including less pain, less scarring and a faster recovery when compared to traditional surgery.  

The procedure also provided a learning experience to neurosurgeons from other institutions, who were present to observe, empowering them with the opportunity to develop a new dimension to their current surgical practices. 

Fatiema Franke, the patient’s mother, said: “Those first few days after diagnosis were very traumatic – we didn’t know what was going to happen and how this would affect him in the future, but we’re glad the operation was a success. He is doing fine and we’ve learned that our child can lead a better quality of life.”

Western Cape Minister of Health, Dr Nomafrench Mbombo, added: “Ground-breaking medical innovation like this will inevitably change the face of medicine. This procedure has afforded little Masslino Franke an opportunity to live and not be defined by multiloculated hydrocephalus. I would like to congratulate the team of doctors who performed this surgery for the first time in South Africa and I wish Masslino a speedy recovery.”