Name of the Procedure:

Excision of Neurofibroma or Neurolemmoma; Extensive (including malignant type)

Summary

This surgical procedure involves removing significant portions of neurofibromas or neurolemmomas, which are tumors that arise from the nerves. The surgery may be performed to treat both benign and malignant forms of these tumors.

Purpose

The procedure is designed to:

• Remove tumors that may be causing pain, neurological symptoms, or cosmetic concerns.
• Prevent the growth or spread of malignant tumors.
• Improve the patient's quality of life by alleviating symptoms associated with nerve compression or tumor mass.

Indications

• Symptoms such as localized pain, numbness, or weakness.
• Evidence of tumor growth on imaging studies.
• Diagnosis of malignancy or high likelihood of cancerous transformation.
• Physical deformity or cosmetic concerns caused by the tumor.

Preparation

• Patients may need to fast for 8-12 hours before the procedure.
• Adjustments to medications, particularly blood thinners, as directed by the surgeon.
• Preoperative imaging studies such as MRI or CT scans.
• Routine blood tests and physical examination to assess overall health.

Procedure Description

1. The patient is administered general anesthesia.
2. The surgical area is sterilized and covered with surgical drapes.
3. An incision is made over the site of the tumor.
4. The tumor is carefully isolated from surrounding tissues.
5. The neurofibroma or neurolemmoma is excised completely.
6. The surgical site is closed with sutures or staples.
7. A drain may be placed to prevent fluid accumulation.

Tools used include surgical scalpels, forceps, retractors, and possibly electrocautery for bleeding control.

Duration

The procedure typically takes 2-4 hours, depending on the tumor's size and location.

Setting

The surgery is usually performed in a hospital or an outpatient surgical center equipped for complex neurological procedures.

Personnel

• A neurosurgeon or orthopedic surgeon specialized in nerve tumors.
• An anesthesiologist.
• Surgical nurses and technicians.

Risks and Complications

• Bleeding and infection at the surgical site.
• Nerve damage leading to loss of sensation or motor function.
• Recurrence of the tumor.
• Adverse reactions to anesthesia.
• Scarring and wound healing issues.

Benefits

• Relief from symptoms such as pain or neurological deficits.
• Reduction in the risk of malignant transformation (if benign) or spread (if malignant).
• Improved physical appearance and quality of life.

Recovery

• Patients usually stay in the hospital for 1-2 days for monitoring.
• Pain management with prescribed medications.
• Instructions to avoid strenuous activities for a few weeks.
• Follow-up appointments for wound check and possible suture removal.
• Physical therapy may be recommended for regaining strength and function.

Alternatives

• Observation and regular monitoring if the tumor is small and asymptomatic.
• Non-surgical treatments such as radiation therapy, particularly for malignant tumors.
• Medications to manage symptoms like pain.

Patient Experience

During the procedure, the patient is under general anesthesia and will not experience pain. Postoperatively, patients may experience discomfort and require pain management. The recovery period involves rest and gradual return to normal activities, following the healthcare team's guidance for optimal healing.