More than 70 professionals participate in the fifth edition of the international course Mapping Bellvitge, where the Hospital de Bellvitge shares its more than 20-year experience in tumour removal surgeries with brain mapping and intraoperative neurophysiological monitoring. With more than 100 brain tumour operations performed last year, the hospital's Neurosurgery Service is a pioneer and a national and international benchmark in this technique.
The mapping technique consists of marking in vivo on the patient's brain areas of high functional eloquence, such as those affecting movement or language. When the patient has a brain tumour near these areas, identifying them accurately is essential for their preservation. To detect the functional areas, a craniotomy is performed and the brain surface is scanned with electrical stimulation. "The procedure requires high expertise and multidisciplinary work involving radiologists, neuropsychologists, neurophysiologists, neurosurgeons, anaesthesiologists and nurses", as Dr Andreu Gabarrós, head of the Neurosurgery Department at the HUB, points out.
The four-day course includes: laboratory work, where brain fibres and preoperative processes are studied using neuroimaging techniques; lectures; and, during the fourth day, two live surgeries, one with the patient awake, to identify language function, and the other with the patient asleep, to study motor function with intraoperative monitoring. When identifying the language areas, the patient needs to be awake for the surgery so that a series of tests can be performed through electrostimulation to precisely locate the specific points of their languages. Once detected, they are marked with labels. The patient's collaboration during this process is key, because it conditions the language points obtained, the degree of resection and, therefore, the global and functional prognosis.
Regarding the movement, the function can be identified with the intraoperative neurophysiological monitoring technique, with the patient asleep.
Brain mapping and intraoperative neurophysiological monitoring have become consolidated as the most indicated technique to achieve the greatest possible resection of the brain tumour, which translates into increased survival and quality of life for patients. As Dr Gabarrós explains, "it has been proven that if the entire tumour is removed, but the patient suffers a neurological deficit, it will have a negative impact, because if it results in any sequelae that limit their autonomy, it will be much more difficult for them to access cancer treatments".
Among the guest speakers at the 5th edition of the Mapping Bellvitge Course are the French neurosurgeons Hugues Duffau, from the University Hospital of Montpellier, and Emmanuel Mandonnet, from the Lariboisière Hospital in Paris, recognised worldwide for their work in language preservation related to brain pathology; Dr Juan Martino, trained at the HUB and now in the neurosurgery team of the Valdecilla Hospital in Santander, and Dr Francesco Sala, from the University of Verona (Italy).