Friends of JDWNRH-Vienna, a society in Austria has donated a high-end neuronavigation equipment worth Nu 30 million to Jigme Dorji Wangchuck National Referral Hospital in Thimphu.

   The handing-taking of the equipment was done yesterday.

A neurosurgeon with JDWNRH, Dr Tashi Tenzin, said that the machine is used to help guide surgeon to operate on brain and spinal cord through computer-assisted programme precisely and with accuracy.

Consultant neurosurgeon with Medical University of Vienna in Austria, Dr Stefan Wolfsberger, said that without a navigation system, a brain surgery took longer and was painful for the patient as the cut would be large.

He said that without a navigation system, it would not be possible for a neurosurgoen to know precisely the location of a tumor. “When you have to operate it, you would want to make the cut on the head exactly at the right position because if you don’t do that and if the cut is made at the side, then you cannot reach the tumor. You then have to enlarge the opening.”

“That is what we had to do when I started in 1997,” Dr Stefan Wolfsberger said. “We did not have navigation systems, so we made large openings and sometimes the openings are not at the right side. We then enlarge the opening further.”

He said such method was dangerous.

Neuronavigation system, he said, was same like a car navigation system. Surgeons put the CT and MRI scans of the patient in the system and use them as a map to navigate and target the tumor.

The equipment, he said, made surgery more efficient because a surgeon always made an opening at the right position. “You can even plan both of these before because this system allows you to.”

Dr Tashi Tenzin with Dr Stefan Wolfsberger, carried out two surgeries at JDWNRH, using the donated neuronavigation equipment on October 23 and 24.

Dr Stefan Wolfsberger said that they had a good example patient on October 24. The most difficult area of the brain, he said was the centre which actually was the part that connects the brain and the spinal cord. It is called brainstem.

He said the patient at JDWNRH had a tumor in the brainstem. “We cannot operate it but we need to know where the tumor exactly is.”

In olden days, an opening was made at a side and the surgeon would push the brain away with fingers to find a tumor which is dangerous. “Most of these patients will not survive this treatment.”

Today, with the navigation system, we saw the tumor and planned what to be done. “We had an entry point at the surface where we made a small hole. A needle was pierced into the tumour and with a help of a suction, a small piece of the tumor was taken out. Its called biopsy.”

“We saw that it is a real tumor,” he said. The sample would be send to a pathologist who would give a diagnosis. “We would then know how the patient can be treated. Without navigation, this is impossible and much too dangerous.”

Dr Stefan Wolfsberger said today, all brain surgeries would be done with navigation because it helped in keeping all danger away and made the surgery smaller which was safer for the patient.

In Bhutan, most of the patients with such cases are referred to India.

“I hope that now, with some training with the two cases, Dr Tashi Tenzin can now do such brain surgeries and treat the patients at the hospital,” Dr Stefan Wolfsberger said.

Dr Tashi Tenzin said that the formation of the society, Friends of JDWNRH-Vienna started when an Austrian tourist suffered thrombosis (clotting of blood) on his leg during his visit to Bhutan in 2013. “It could have caused loss of his life.”

Health staff at the Bumthang hospital and JDWNRH treated the tourist. As a token of his appreciation, the tourist and his team invited Dr Tashi Tenzin who operated on him to Vienna for training in their university hospital in 2015.

The training was funded by the patient and his team. Dr Tashi Tenzin worked with Dr Stefan Wolfsberger then.

“Dr Stefan Wolfsberger asked me what could he do to help improve neurosurgical care in Bhutan when I asked for a neuronavigation system which was too much to ask for,” Dr Tashi Tenzin said. “He said he would try.”

A year later, Dr Stefan Wolfsberger said he managed to get one for Bhutan. Friends of JDWNRH-Vienna helped in shipping the equipment weighing 430kg to Bhutan. Dr Tashi Tenzin underwent basic training on the use of the equipment in Last July in Vienna.

Dr Tashi Tenzin said, “All these happened through our good will of our health care system and individual friendship.”

Expressing his appreciation to the society’s representatives and resident coordinator of Austrian Development Cooperation, JDWNRH president Lhab Dorji said the donation to the hospital would help the patients across the country.

Dechen Tshomo