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Introduction

 

The Department of Neurosurgery at Sri Venkateswara Institute of Medical Sciences was started in September 1993. The department has made great strides forward since then, in rendering modern neurosurgical services to patients. With the acquisition of state of the art equipment it has evolved into a full fledged and one of best equipped neurosurgical centers in state of Andhra Pradesh.

As the work load increased the faculty has been strengthened. Neurosurgeons trained in some of the best centers in India viz., National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore and CMC Vellore. The department caters to the people of Rayalaseema in particular and also gets referals from entire Andhra Pradesh, neigbhouring states of Tamil Nadu, Karnataka and even as far as east coast of India.

The department of Neurosurgery at SVIMS has been providing round the clock emergency services to the patients in addition to performing complex surgeries of brain and spine in specialised fields of Neurosurgery.

SUB SPECIALTIES IN NEUROSURGERY AND THEIR DEVELOPMENT

The department has carved a niche for itself in the field of Cerebrovascular surgery. This department has the distinction of performing complex surgeries involving the blood vessels of the brain for brain haemorrhage and stroke like aneurysm clipping, excision of arteriovenous malformation of brain, STMC anastamosis using adjuvants like hypothermia and cardiac stand still making Tirupati as the only city other than Hyderabad where cerebrovascular surgery is routinely being performed. The department is in process of establishing a Data Bank of cerebrovascular diseases for the state of Andhra Pradesh.

 The department of neurosurgery at SVIMS has forayed into the field of minimally invasive neurosurgery developing stereotactic and neuroendoscopic neurosurgery. Our department is second in state of Andhra Pradesh and first in Public Sector to acquire Computer Guided Stereotactic equipment. This equipment used for accurately localising lesions in brain utilising computer and is used in diagnosis and treatment of various cerebral diseases. It is especially invaluable in management of small, multiple and deep seated cerebral lesions.

The department has recently acquired neuroendoscopy equipment (Second in the State) and is one of the few centers in India to boast of this advance in neurosurgery. This is used to operate on tumors within the ventricles of brain and for management of hydrocephalus. It will also be incorporated during micro neurosurgery to assist surgeons in providing better 3D vision in deep seated areas of brain.

The department has developed skull base surgery specially for management of lesions at base of brain. This surgery is immensely facilitated by the use of Midas Rex pneumatic drill system and ours is the only department in state of Andhra Pradesh to acquire this equipment.

The department performs transphenoidal surgery for pituitary and other brain tumors where the tumors are approached through the nose. This greatly reduces the morbidity associated with surgery and hastens post operative recovery. This surgery is available in very few Neurosurgical centers of Andhra Pradesh.

In the field of spinal surgery; spinal instrumentation subspeciality has been developed at our department. Trans oral surgery, cervical, dorsal and lumbar instrumentation are being routinely performed for spinal injuries, tuberculosis and tumors. Microlumbar and cervical discectomy are done to decrease the morbidity associated with surgery and for faster recovery. Spinal reconstruction surgeries like cervical laminoplasty are undertaken in the department.

Another important contribution of the department is in the field of management of severe head injuries which involves critical care and ventilatory management in addition to surgical intervention. Earlier, critically ill patients from this region of Andhra Pradesh had to be transported to Madras, Vellore and Bangalore during the crucial "Golden hours" following head injury with resultant disastrous consequences. Now these patients are being managed at SVIMS. With financial assistance from Chief Minister Fund treatment for these unfortunate patients, most of whom are young is being rendered at Tirupati, at affordable by the common man.

In addition to these specialized fields of neurosurgery, the department performs routine microneurosurgical procedures assisted by the armamentarium of equipment which include Zeiss CS.NC II operating microscope, Ultrasonic surgical aspirator, Aesculap Elan E motors, craniotomes and a range of micro instruments. 

 

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