What is Functional Surgery?
Functional surgery is a specialized type of surgical technique that utilizes advanced technologies and special devices to restore lost functions, reduce pain, and help control certain conditions. It is particularly applied in cases where patients experience functional impairment in their bodies.
In neurosurgery, functional surgery is successfully used for the treatment of the following conditions:
- Hydrocephalus
- Parkinson’s disease
- Hand tremors (Tremor)
- Involuntary movements (Dystonia)
- Stiffness in arms and legs
- Muscle contractions in arms and legs (Spasticity)
- Epilepsy
- Pain management
- Sphincter control loss
Functional surgery includes advanced and continuously evolving treatment methods such as:
- Neuroendoscopic surgical techniques
- Stereotactic surgical techniques
- Surgical guidance systems used during procedures, including neuromonitoring and neuronavigation
- Neurophysiological systems such as deep brain stimulation, spinal cord stimulation, and nerve stimulation
- Pressure-sensitive systems such as shunt surgery
Functional surgery can significantly improve patients' quality of life by correcting functional impairments or aiding in better control of certain conditions, thereby enhancing their overall health and well-being. However, like any surgical procedure, it carries risks and potential side effects. Therefore, consulting a physician before undergoing any surgical intervention is essential.
Types of Functional Surgery
Functional surgery encompasses a variety of techniques applied in different medical fields. Some common types include:
Stereotactic Surgery
This is a minimally invasive, high-precision method used to reach lesions in the brain. A 3D coordinate system is utilized to accurately target the lesion, allowing for procedures such as biopsy, stimulation, and radiosurgery.
Neuroendoscopic Surgery
Neuroendoscopy involves using an endoscope to access the surgical site with minimal tissue disruption, enhancing the precision of the procedure. Neuroendoscopic surgery is widely used for:
- Pituitary Surgery
- Endoscopic Discectomy
- Endoscopic Hydrocephalus Surgery
- Intraventricular Tumor Surgery
- Skull Base Surgery
Since it is a minimally invasive approach, hospital stays are generally shorter, and patients can return to daily life sooner.
Deep Brain Stimulation (DBS)
DBS is used to treat conditions such as Parkinson’s disease, hand tremors (Tremor), and involuntary movements (Dystonia). Electrodes are placed in specific brain regions using stereotactic surgical techniques, and a control unit outside the body adjusts the stimulation based on the patient’s response.
Vagal Nerve Stimulation (VNS)
For epilepsy patients who do not respond well to medication, VNS is used to stimulate the vagus nerve with electrical impulses, reducing the frequency and severity of seizures.
Spinal Cord Stimulation (SCS)
In cases of spinal cord injury or persistent pain despite surgical treatment, spinal cord stimulation helps activate nerve cells and regulate the pain control mechanism, thereby reducing pain levels.
Sacral Stimulation
This technique is used for treating bladder control disorders and erectile dysfunction (impotence).
Shunt Surgery
In hydrocephalus patients, when cerebrospinal fluid cannot be properly absorbed or flow is obstructed, it leads to an increase in intracranial pressure. Shunt surgery involves placing a drainage system to divert excess fluid to the abdominal cavity or the heart to relieve pressure.
Baclofen Pump Implantation
Used for patients with spinal cord injury or cerebral palsy who experience muscle stiffness (spasticity), which limits movement. A baclofen pump is implanted under the skin in the abdomen, with a catheter placed into the spinal cord. This allows for controlled delivery of baclofen, reducing systemic side effects while providing effective symptom management. The pump can be monitored and refilled externally when necessary.
Conclusion: Functional Brain Surgery
Since functional brain surgery involves delicate procedures on brain tissue and the nervous system, it carries inherent risks. However, with proper patient selection, the use of appropriate surgical techniques, and thorough postoperative monitoring, these risks can be minimized. Functional brain surgery can be a highly beneficial option for eligible patients, significantly improving their quality of life.
Op. Dr. Eyüp Genç
