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00:01in the heart of Liverpool okay let's go is an operating theatre like no other
00:14doctors are the pinnacle of their profession ah big nest of vipers that's all totally abnormal
00:20fight to save lives are you alright buddy a bit of pain there yes straight down my face in
00:27neurosurgeon being able to change lives for the better there's no other job that I'd rather be
00:32doing it's high-stakes surgery this is amazing I've not seen anything like this before if you
00:41cause an injury to the brain or the spinal cord you can't repair it that's it forever using
00:46groundbreaking technology making life-or-death decisions oh yes a sea of blood if we don't do
00:55anything should die he needs to wake up I think it's gone well it feels really good I love it
01:02when a pun comes together this is trauma room one the Walton Centre in Liverpool performs 2,000 emergency
01:18operations every year and an ambulance is on route with a patient in a critical condition 58 year old
01:29Rachel has been rushed in after collapsing at a nearby A&E department with a bleed on the brain it's
01:37an
01:37emergency so it's going to move this side okay so we can transfer you the patient is unconscious and
01:43needs urgent help she had a cardiac arrest in Arrow Park lucky it was witnessed and the team were able
01:49to to jump on and intervene right then and there the bleed was caused by a ruptured aneurysm a weak
01:59bulging area in an artery wall Rachel's future is in the hands of consultant interventional radiologist
02:08dr. Faye Babatola three one two three the cause of her bleeding intracranially looks like it's an
02:16aneurysm coming off one of her vertebral arteries this is a problem because that's the pipe that goes to
02:22the back of her head and supplies her brainstem so what we need to do now is map out all
02:27her blood
02:27vessels and see what treatment options are feasible for her there is a risk that if we leave the
02:33aneurysm alone she might we bleed but if I block off the aneurysm and ruin her brainstem I've not
02:40done her any favors whatsoever dr. Babatola's first task is to find out what can be done that won't make
02:49matters worse one of her vertebral arteries is the problem the question is is the other one big
02:57enough to do the job of both of them if it's big enough we can just get rid of the
03:01vertebral artery
03:01on the same side of the aneurysm on it and that'll stop her from bleeding in future if the other
03:06one's
03:06not big enough then there's a risk of giving her a big brainstem stroke okay Rachel sharp scratch
03:16coming now a bit of stinging and a bit more stinging deeper down now dr. Babatola inserts a catheter into
03:25a blood vessel in Rachel's groin and we're all done and guides it to the site of the aneurysm we've
03:36got an
03:36empty syringe for a CT the first part is the angiogram so basically what I'm trying to do is get
03:43into the
03:43feeding vessel that has the aneurysm on it so I'm just having to do what we call a road map
03:48we did
03:50a scan with some dye injected into the veins wait for it to go around to the arteries in her
03:55head
03:58take another scan and it lights up the blood vessels and then you can see this pouch sitting on the
04:04vertebral artery and it's pretty obvious that's where the blood's coming from this bulge here is the
04:13aneurysm the 3d model I need to have a proper look at it but I can't do that while I'm
04:17scrubbed but
04:19thankfully dr. Pulacino he's gonna get my projections for me and I'm gonna carry on with the angiogram
04:25stay very very still the scans will determine whether anything can be done to save Rachel's life
04:39there are 20 consultant neurosurgeons screen can go backwards please five consultant orthopedic surgeons
04:46and 27 specialist nurses working at the Walton Center and today 42 year old Michael is being prepped for
04:57surgery he has a rare condition that needs urgent attention symptoms starting a couple of years ago
05:04experiences of dizziness feeling like I was gonna blackout or pass out Michael has a blockage of an
05:14opening deep within the brain that's causing a buildup of fluid hopefully I can move on just to
05:21get back some sort of normality for the operation to be a success and life returning to normal really
05:31and that task is in the hands of consultant neurosurgeon professor Michael Jenkinson Michael he's had several
05:39months of episodes of headaches with some collapses and it turns out he had viral meningitis when he was 19
05:47and this has scarred some of his fluid systems within his brain and it's getting intermittent
05:53rises and spikes in brain pressure that's causing these symptoms what we're gonna do today is have a
06:01look on the inside of his fluid cavities and if we can see the scarring and the narrowing and it
06:06looks
06:06reasonable we're gonna put a little balloon in and try and inflate that and make the fluid pathways flow more
06:13readily
06:17this is the MRI of Michael's brain these dark spaces here they're the ventricles the fluid cavities they're
06:25very dilated and enlarged they normally drain through these very small holes into another fluid cavity and
06:33this is where the blockages it's a bit like if you imagine the plug hole in your bath if you've
06:39got a
06:39load of hair in the plug hole the back will gradually fill up so what we're hoping to do is
06:44go in with
06:44our camera unpick the hair in the plug hole so to speak and re-establish the flow of fluid through
06:52his
06:52brain professor Jenkinson is performing an endoscopic or keyhole surgery this is an excellent case to treat
07:03with endoscopic surgery this allows us to put a camera into the fluid cavities so we're just marking where we're
07:11going to make our entry through the skull and see exactly what the problem is and address that problem head
07:18-on
07:19the risk we always warn people about stroke or risk of death but the pathway that we're trying to open
07:27is very close to his
07:29memory circuits so the risk is if we open up the pathways we can impact his memory so that's what
07:35the balance is can we do something without making him worse for Michael it's a risk worth taking okay
07:43starting and with a mono please 58 year old Rachel was rushed to the hospital after collapsing with a
08:09ruptured brain aneurysm we do the timeouts a condition that is fatal in about 50% of cases just
08:18relax for me dr. Babatola has taken scans of Rachel's brain to pinpoint the exact location of the bleed he
08:30confers with his colleague consultant interventional radiologist dr. Richard Pulicchino I've done a
08:38vertebral run and spin and I think it's a dissecting aneurysm you know I don't think there are any vessels
08:44nearby
08:47we know she's had a bleed and this is adjacent to the bleed so this is what is known as
08:52a dissecting aneurysm
08:54if you don't do anything there's a risk of it re-rupturing and the second bleed tends to be much
09:00worse than the
09:01first bleed and there's a higher chance of mortality and morbidity so it's important that we do we offer her
09:08something now looking at the scans with dr. Pulicchino I thought okay there is an abnormality here and my
09:16options are I can get rid of this whole vessel or we could go in and just fill it in
09:21and block it off which
09:23is what we opted to do dr. Babatola is going to perform an aneurysm coiling the procedure involves
09:33inserting a catheter into an artery in the groin the tube is guided through the network of blood vessels
09:40up into the head and finally into the aneurysm platinum coils are then passed through the tube
09:48into the aneurysm once it is full of coils blood cannot enter it which prevents it growing or
09:55rupturing Rachel so we found the cause of your bleeding you've got an aneurysm in your head
10:03and you think we can get rid of it and I think that's the safest thing for you at the
10:05moment because
10:06the biggest risk to you right now is if that bleeds a second time so get you off to sleep
10:11and then
10:11we'll do that as soon as possible risks of not doing this is that she has another bleeding dies
10:22bit of RAO please the main complication but happens less frequently is there is a risk of having a
10:28stroke maybe when we are interfering with a blood vessel that goes to the back of her head if any
10:32clots form they can go into the basilar artery and cause problems so I just have to be very careful
10:38and hope I don't cause any problems can you follow me up please exactly the same as my angiogram
10:47the difference is I've changed to a larger sheath in the groin so I can take this larger guide catheter
10:54I can then take thinner wires and tubes up past the aneurysm and into the aneurysm and then seal it
11:01off with platinum coils yeah that's good and then can I have a road map there please
11:11okay let's see what we're dealing with it's a risky procedure but it could save Rachel's life
11:28as the radiology team fight to save Rachel another patient is undergoing urgent surgery
11:3942 year old Michael has a rare condition blocking an opening deep in his brain
11:44causing a dangerous buildup of fluid we're just cutting through this scalp consultant neurosurgeon
11:51professor Jenkinson is being assisted by neurosurgical registrar mr. Ahmad Ali
11:58yeah that looks good well there's his coronal suture we're all good man
12:08that's good radio Ahmed is just opening the juror that's the tough outer lining of the brain
12:17oh that's perfect okay yeah and under this layer we'll see the surface of the right frontal lobe
12:24the right side of the brain we're just making a opening so that we can get this long sheath through
12:34the
12:35brain tissue and into the fluid calvertis this allows us to do it with image guidance so sat nav for
12:43the
12:43brain for entry absolutely bang on that's perfect so in the bottom right image there we can see the
12:53two circles lining up and you want to keep them on target this is where I misspent youth comes in
12:59handy
13:00having played too many video games first-person shoot-'em-ups so you've got to get those two
13:05circles lined up that means you're bang on target with your trajectory so that you can get the camera
13:10into the fluid cavities first time and without damaging the rest of the brain can we have the top
13:16lights off then please look at that so on the left where there's that big hole that should be a
13:28fully
13:29formed membrane and what Michael's got here is that that wall has been thinned down and weakened and
13:36there's holes in it that's amazing not for Michael but you can see here the consequences of viral
13:46meningitis which is a an infection and an inflammation in the brain tissue and you get scar tissue formed in
13:5515 years as a consultant 10 years in training I've not seen anything like this before
14:137 a.m. in Liverpool the staff at the Walton Centre are already hard at work
14:21and today is a day that could change 36 year old Scott's life forever father of three Scott was
14:31working out at his local gym when he felt a pain in his back his GP sent him for an
14:36MRI scan the results
14:39were devastating I have a tumor that's grown on the inside of my spinal cord and is pushing on the
14:51nerves so I'm numb from the waist down and I have issues walking because I can't keep me balance or
14:56the strength in my legs is not there basically you take for granted certain things like just walking
15:03and I was active with my kids taking them to their rugby training I can't even do that because I
15:10can't
15:10drive a car what I'm hoping for is basically the pain to stop and some sort of
15:18basically just get back to normal life wife Sophie is hoping for the same thing I'm really nervous
15:28trying to keep it all together but I think today's a little bit of closure maybe just to improve his
15:39quality of life have his independence back it mean the world just to get back to some normality
15:47consultant neurosurgeon mr. Suresh Chandrasekharan is preparing for surgery he's a gentleman who's 36
15:54years old who presents with gradual decline of his mobility he's had a scan which revealed a thoracic
16:01tumor to get to this tumor we need to first localize the level which is a T5 T6 we will
16:10open it up and
16:11then take the tumor out it is a big serious operation the thoracic cord is unforgiving any
16:18manipulation of the thoracic cord could lead to paralysis he can be paralyzed from his waist below
16:30completely it's a challenge no two tumors are alike each one is different it's a different route to get
16:37to the same thing so the scenario changes it's like driving different routes each time you go home
16:46starting mr. Chandrasekharan is going to perform a laminoplasty the consultant will remove a section
16:57of bone that covers the dura which protects the spinal cord once they open the dura they can access and
17:05remove the tumor when the tumor is removed if the bone is intact they will screw it back into place
17:15I chose to do a laminoplasty because this gentleman is quite young and there are possibilities that if
17:21you take the bone off they can always develop instability and they can develop kyphosis later
17:27on in life so restoring the normal anatomy would be the best in a in a younger patient it's not
17:34going
17:34deep enough it's always a challenge operating on thoracic tumors because it's always a risk of
17:41paralysis but you got all the precautions needed and yeah we'll take all the necessary care and get
17:57the surgery done one in 15,000 people suffer a ruptured brain aneurysm in England each year of those who
18:07survive about 66 percent have some permanent disability consultant radiologist dr. Babatola my
18:18catheter first please is carrying out an aneurysm coiling on 58 year old Rachel there's a few torturous
18:26loops I've got to go around and then I'll be inside the aneurysm and then we start coiling thank you
18:33the issue is here we think that's where she's bled from so as long as I don't poke that we
18:39should be okay
18:42so onwards and upwards
18:51okay spin
18:58that projection doesn't allow me to get past the aneurysm
19:03so I'm just going to park this one here
19:07after one or two attempts I thought this is too risky I'm going to end up going straight through
19:12the blood vessel with one of my wires and that's exactly what happened to me I ended up poking it
19:17thankfully it didn't bleed but I gave up trying to get past almost immediately once it happened
19:21and just filled the aneurysm in the vessel from that point on
19:26and we have 5,000 units of heparin please
19:30so I've got both micro catheters into the aneurysm so now I'm going to deploy my first coil
19:40push please
19:47right we are in
19:50so can I have a three by six hydrophil as well and then we'll go with some smaller hydrosofts and
19:55hopefully finish this off
20:01I'm blocking off the whole aneurysm and the blood vessel with it because that's the only option for
20:05this one because can you see this black line here that's blood coming in from the other vertebral artery
20:11so if we block this that will store supply everything if she only had this artery and
20:18not the other ones then this would not be a viable tactic for her
20:25but just as plan b seems to be on track
20:30this isn't working coils stretched
20:33I don't want to rupture this dissecting aneurysm so I'll choose a soft catheter
20:37but then I have to get something a bit firmer
20:40I have an echelon 45 degree instead of that this is too soft
20:44in order to be able to push these coils in and actually seal off the blood vessel
20:48by which time I was far enough away from the rupture point that it wasn't going to be an issue
20:53so now I need to figure out how I get this back in
20:59this all takes time a luxury Rachel doesn't have
21:23consultant neuroradiologist Dr. Babatola is performing a life-saving coiling procedure
21:28on 58-year-old Rachel
21:31she was rushed to the hospital with a life-threatening bleed on the brain
21:35I need to fill this like aneurysm sack and then come slightly into the vessel
21:41the problem is always when do you stop
21:46that bit's still filling
21:48nearly blocked off this bleeding point
21:50that's the main priority
21:51so though it looks pretty dense when you look at it like that
21:54there are gaps in between
21:56so I need to block off the vessel
22:05so now we've done the risky bit
22:07I'm going to stop there
22:09have a road map there please
22:11all I need is good enough to stop her from having a second bleed
22:14trying to get a perfect result can often land you in trouble
22:18perfection is the enemy of good
22:25yep it's worked
22:29so if we look at the previous run that I did
22:32so you can see how the blood was coming up
22:34and then going through
22:36so now
22:39you see how this bit's not even filling
22:43and that's it
22:45all finished
22:50so successful
22:51we've managed to block off the bleeding points
22:54it is filling a little bit from the back end
22:56but it's not reaching the actual aneurysm itself
22:58so that should be okay
23:04it was just difficult to get the coils into the right place
23:08but we've managed to achieve what we set out to do
23:11which is block off the artery and the aneurysm
23:15so we need to keep an eye on her for the next two weeks
23:18so everyone's different
23:19some patients recover fully
23:21other people you know
23:22not back to work but living their lives
23:23but some people even though we've done all this
23:26still don't survive because of other complications
23:29so we'll see which one she is
23:38the spinal service at the Walton Centre
23:40is one of the busiest in the country
23:42and in theatre three
23:4436 year old Scott
23:46is undergoing major surgery
23:48to remove a tumour from his spinal cord
23:52ready for the microscope
23:57this is T5 and 6 lamina
23:59so we're going to take these two off
24:01and then we'll get the dura underneath
24:04can I have an up cut please
24:06one millimetre
24:07they're working millimetres
24:09from critical structures in the spine
24:15so that's the midline
24:16so we're going to drill two trenches
24:18and see if you can take the bone in total
24:19and under the bone is the dura
24:21and that's where the tumour lies
24:25drilling near the spinal cord
24:26you've got to be very careful
24:27and very meticulous
24:28because even the slightest inattention
24:30can cause the drill to go into this cord
24:33and cause permanent damage to the spinal cord
24:35there's also the blood supply of the cord
24:38called the artery of Adam Kivich
24:40which if damaged can cause a thoracic cord stroke
24:45and that can lead to debilitating injuries
24:49like paralysis
24:51up cut please two millimetre
24:53because we take all precautions
24:55not to do that and avoid as much as we can
24:57any sort of unnecessary damage
25:01just trying to take the bone out
25:02to get to the dura
25:05lexotomy please
25:06I'm planning to do a laminoplasty for this gentleman
25:09which is laminectomy is removing the bone completely
25:13versus laminoplasty where we put the bone back in
25:17putting the bone back in
25:18retains a normal anatomy for the patient
25:20and it also prevents the chances of instability
25:26getting the bone back in
25:26but you've got bone there
25:27sorry
25:28you've got bone there
25:29bone there
25:36it's moving
25:46we've got the bone out
25:51we've taken the bone out now
26:02so let's stop this bleeding
26:03can I pull it down to ten please
26:07removing the bone has revealed an extra complication
26:11so you can see a large blood vessel on top of the dura
26:13a vein on the dura
26:17and our tumour is underneath this bit here
26:19but we've got to sort this vessel out before we do anything
26:22an already complex operation just got even harder
26:37one of the rarest cases professor jenkinson has ever seen
26:4242 year old michael is undergoing complex elective brain surgery
26:49this is amazing
26:50I've not seen anything like this before
26:54assisted by mr. ali
26:56professor jenkinson is performing an endoscopic procedure
26:59to open up a blocked fluid pathway
27:02you can see here
27:04that little hole right in the middle of the screen
27:06and that is absolutely tiny
27:10so normally fluid from this cavity here
27:14that should flow through that hole
27:16into another cavity
27:17and that's why I think it's causing the issues
27:22we've got a monopolar
27:23if we make this the septum bigger
27:25we can just have a quick peek over the other side
27:30okay that's off a second
27:35we're making a bigger hole
27:37in this bit of tissue
27:39this is called the septum pellucidum
27:41it's the normal membrane
27:43that divides the two cavities
27:47when we do this operation
27:49this is what you could describe as advanced plumbing
27:53re-establishing fluid pathways
27:56diverting fluid
28:00let's give you that back
28:02oh and actually look at that
28:03that hole seems to be getting bigger
28:05just I mean we're not doing anything yet
28:07but it seems to be a bit bigger
28:09right you got that balloon then
28:11I think this might work you know
28:12I'm quietly optimistic
28:15the balloon is there to slowly and gently inflate the fluid pathway
28:20we can do that in a quite a controlled way
28:22and it prevents us from damaging the surrounding structures too much
28:28right we're not going to inflate
28:30I'm just going to see if this balloon will bit and pass through
28:37look at the size of that
28:38I mean that's ridiculous right
28:39this is a two millimeter balloon
28:42the opening called the foramen of Munro
28:45should be five millimeters in a healthy adult
28:50can I have the EM stilette instead
28:52let's try that which is a bit more rigid
28:55the stilette makes it easier to maneuver through the delicate brain tissue
29:00I mean I feel like you've widened it now
29:02the balloon could fit now
29:03I think the balloon will fit
29:09just gently inflate there
29:14perfect just hold it there
29:18during the operation I had to decide
29:20how wide we had to make the opening
29:23to be wide enough that it allowed good flow of fluid
29:26but not so wide that we risk damaging his memory circuits
29:30what I can't tell is whether there's any membrane underneath
29:37and there's no real way of telling that during the operation
29:41it's just a sort of sixth sense
29:43a judgment that you have to make at the time
29:46and think that looks about right
29:50Michael's future is depending on it
30:02over 50,000 spinal surgeries are performed in the UK every year
30:07and earlier today dad of three Scott
30:10was admitted to the hospital for an emergency surgery
30:13to remove a tumor from his spinal cord
30:19so let's stop this bleeding
30:21I'll have the bayonet and surgery cell please
30:24but consultant neurosurgeon Mr. Chandrasekharan and his team
30:28have hit a problem
30:30there's an enlarged vein just where the tumor lies
30:35there's always a risk of bleeding
30:36so we have to either see if you can preserve it
30:38or sacrifice that blood vessel
30:41it's a setback they don't need
30:44it's called an epidural vein
30:46it was restricting the access into the tumor
30:49where we have to open the dura up
30:50it was coming in the way of the operative site
30:53it was just mainly on top of the dura
30:56so we decided to sacrifice it to enable better access
31:00we have to sacrifice a vessel
31:15with all obstructions out of the way
31:17Mr. Chandrasekharan can now open up the dura
31:20to access the tumor
31:22inside knife please
31:31spinal fluid coming out
31:36can we have some hit stitches please
31:41that's the tumor there
31:42that you see the white thing there
31:48clip and cut please
32:01okay
32:03that's tumor
32:08if you look there what you've got is a tumor
32:11that is pearly white substance
32:15some more tumor
32:16this was a free floating tumor
32:18it wasn't attached to any structure
32:20it was just pressing on the spinal cord
32:23it's a very very rare tumor
32:25it's less than one percent of the spinal tumors
32:28some more tumor
32:31but removing the tumor
32:32is just the start of Scott's treatment
32:35wash please
32:37once it's excised
32:38we send it for histology
32:40where the neuropathologist
32:41will have a look at it under the microscope
32:43and give us a diagnosis
32:44and helps us with further treatment
32:49we have taken all the tumor out
32:52we're just closing the dura up
32:54and then we'll put the bone back
32:55and then close up
33:02hopefully he should be as he was pre-operatively
33:05and as time goes by he will improve
33:07because we've taken the whole compression off
33:10we're going to close up now
33:11so we'll see what he does when he wakes up
33:15thank you
33:18it went fine
33:19we've taken all of the tumor out
33:20we need to wait for a formal result
33:22if it is what I think it is
33:24an epidermoid
33:25then he would not need any further treatment
33:26which is good
33:29and it's essentially rehab for him
33:31from now on
33:32to see how much of improvement he will have
33:35any thoracic tumors
33:36usually take some time to improve
33:38post-operatively
33:39he was weak on his left leg to start with
33:41and the right hips as well
33:43so I'm hoping it will be gradual improvement
33:45in weeks to come
34:0012 days ago
34:0158-year-old Rachel
34:03was rushed to the hospital
34:04after collapsing
34:05with a life-threatening bleed on the brain
34:08okay
34:09two minutes of noise for the scan now
34:12an aneurysm coiling
34:14saved her life
34:15and today she's having an MRI scan
34:18to check on her progress
34:24the results were positive
34:26and four days on
34:27she's going home
34:30it's all happened like a complete whirlwind
34:33it doesn't feel like 16 days
34:36it's like a big blur of headache
34:38and pain relief
34:43originally they said
34:45I might go home next week
34:46then somebody said
34:48pack your bags
34:49you're going
34:51hell I'm trying not to burst into tears
34:53I was so happy
34:54a woman over the way from me
34:57said she saw my face going
34:58and she burst into tears
35:00poor me
35:05very lucky
35:06originally I was very blasé to that thought
35:10but as I recovered more and more
35:13I can't believe that I drove to the hospital
35:16and probably within 10 minutes
35:19I'd flatlined on the floor
35:22I'm so relieved
35:24that it all went in the right order at the right time
35:28very lucky
35:30very lucky
35:45the Walton Centre, Liverpool
35:49where yesterday
35:5136-year-old Scott had complex spinal surgery
35:54to remove a tumour
35:56that was having a severe impact
35:57on his mobility
36:02consultant neurosurgeon
36:03Mr Chandra Sekharan
36:04is doing his morning rounds
36:07I'm going to see Scott now
36:08post-operatively
36:09see how he's doing
36:10assess his lower limb power
36:13I'm hoping he'll be much better
36:14than what he was yesterday
36:17how are you doing?
36:18I'm okay
36:18in pain?
36:20yeah it's expected
36:21pain usually gets worse
36:22before it gets better
36:24okay
36:24let's see what you can do
36:25with your legs
36:26okay bend your knees up
36:28straighten them out
36:29good
36:29and this one
36:31straight straight
36:32straighten them out
36:33great
36:34okay
36:34pull your feet up
36:36towards you
36:37okay big toe up
36:39great
36:40how's the sensation?
36:41feel better
36:43any questions?
36:45no
36:45no
36:45good
36:46thank you
36:48very very pleased
36:49with how it's come up
36:50he was really weak
36:51on the left leg
36:52before we started
36:52and now he's got full power
36:54so I'm really pleased
36:55much better than what I expected
36:57I'm really happy
37:00four days later
37:01and Scott is having physio
37:03to get him moving again
37:05or I lead him at the right
37:08just not come like
37:09see doing that
37:10so again just
37:11step together
37:13nice and slow
37:17good
37:19he's done really well
37:20it's really nice to see
37:22and before his operation
37:23he had quite a lot of weakness
37:24in his leg
37:25you feeling okay?
37:26yeah
37:26but he's had a lot of improvement
37:28in it
37:28that's it
37:29so we'll be sending him home
37:30with the crutches
37:31and then we'll put in
37:32community therapy
37:33he'll hopefully progress off them
37:35and we've practiced the stairs
37:37and we know he's going to manage them
37:38when he goes home
37:38yeah I think it'll just
37:40take me time
37:41yeah
37:41you're saving you steady
37:43it was good to walk like that
37:45to have a little bit of freedom
37:47being stuck next to the bed
37:48and asking for help
37:49it's not a nice thing to
37:50to go through
37:53and I didn't think I'd be in this
37:55position where he am now
37:56from when I first come in
37:57I honestly believed I was going to be
37:59still in bed
38:00and not at this stage
38:02where he am now
38:15the Walton Centre
38:16perform almost 4,000
38:18elective surgical cases a year
38:23in theatre
38:24Professor Jenkinson
38:26is using a balloon catheter
38:27just gently inflate there
38:29to open up a blocked fluid pathway
38:32in 42-year-old Michael's brain
38:35and deflate
38:37there's fluid now
38:38you see this flow
38:39yeah yeah there is
38:40there's more definitely more
38:41I mean if the scar process
38:43has burnt out
38:45there's not going to be
38:46an active scarring
38:47inflammatory process
38:48so he may not need
38:50a huge amount of help here
38:53inflate
38:56it's perfect
38:59this is like an isometric contraction
39:02we're doing horse stumps
39:04let me just have a wash again
39:10I mean that definitely looks bigger
39:12it's definitely bigger
39:13I mean it's a lot bigger than it was
39:16I guess the question is
39:17how much you push it
39:19if we keep inflating this balloon
39:21over and over again
39:22that's putting more pressure on the brain
39:24more pressure on those memory circuits
39:26and the more you do it
39:27the more you increase the risk for Michael
39:28that his memory is worse
39:30and that's why you have to stop
39:32when you wake up from brain surgery
39:34you're not going to be the same
39:35as before you went to sleep
39:36because we've been in your head
39:37so I'd expect that his memory might feel
39:40temporarily worse
39:41but it's the long term
39:43that you want to
39:44minimise harm to
39:47I think we should call that a day
39:49I agree
39:50we can give him a chance
39:51to see how that works
39:52we can review him back in the clinic
39:54and see how he goes
39:56lights back on please
39:59that's pretty good
40:00woohoo
40:01that went way better
40:02than I thought it was going to go
40:05I'm going to de-scrub
40:09Michael's operation's gone really well
40:10I'm really pleased with how that went
40:13I was a bit worried before the operation
40:15I didn't know what we were going to find in there
40:18every surgeon wants the operation
40:20to go well for their patient
40:21with no major bleeding
40:24no major complications or issues
40:26that's what surgeons like
40:28routine and straightforward
40:30and goes to plan
40:33Michael will go around to recovery
40:35he'll go up to the ward later on today
40:38he may notice a temporary worsening in his memory
40:42but I'm hopeful that that will not be a long-term issue for him
40:47Professor Jenkinson will find out soon
40:50when he does his afternoon ward rounds
41:01five days ago
41:02father of three
41:03Scott
41:04had major surgery
41:05to remove a tumour from his spine
41:07okay
41:09rest tumour
41:12today
41:13he's preparing to go home
41:15excited to come home
41:16yeah
41:16wife Sophie
41:18and son Kai
41:19are by his bedside
41:20yeah
41:21they're loving being in hospital
41:24three meals a day
41:25working on hand and foot
41:29she had relief
41:31the day he came out of surgery
41:33wasn't great
41:34but since then
41:35he looks absolutely amazing
41:37he's shocked me a little bit
41:38how quick the recovery has been
41:40so yeah
41:42I'm really relieved, happy
41:45I'm looking forward to getting home
41:47home comfort
41:49try and get back into some normality as well
41:53we'll wait on him hand and foot for so long
41:55and then
41:56you've got to promote some independence back
41:58haven't you
42:10just four and a half hours ago
42:12Michael had major brain surgery
42:19wife Sam
42:20is by his bedside
42:22I can't quite comprehend what's happened this morning
42:24doesn't feel like I've been
42:27through surgery at all
42:28never mind
42:28severe surgery
42:29really feel really well
42:31really good
42:32balance is great
42:33I can get up and move about
42:36I'm genuinely quite shocked by that
42:38yeah
42:40Professor Jenkinson and Mr. Arley
42:42check in on him
42:44hi
42:45here he is
42:46the Lionel Messi of neurosurgery
42:48I'll go with that
42:48how are you?
42:50yeah sure
42:51alright
42:54good
42:55how are you feeling?
42:57absolutely spot on
42:58any headaches?
43:00tiny bit of discomfort
43:01when I first came on from the general
43:02but other than that
43:03it's been
43:03been alright
43:04yeah
43:05good
43:05so the operation went well
43:07we got in there
43:08we could tell there'd been something going on there
43:1020 years ago
43:11yeah
43:12and there was a tiny little hole
43:14all your fluid is draining down
43:15was probably blocked
43:16and we've
43:17nicely opened that up
43:18and we saw some good flow
43:19so
43:20all being well
43:21we can get you home
43:22you know
43:22you'll be able to judge
43:23how your brain feels
43:25how your memory feels
43:27impressed and astounded
43:28how just simply walking
43:29from the bed to the toilet
43:31in terms of balance
43:32and everything
43:32it's
43:33it's like nothing's happened
43:34right
43:35it's always nice
43:36when you come across
43:37a condition
43:38where you can do an operation
43:40and actually change someone's
43:42quality of life
43:43good
43:43thank you so much
43:44okay
43:44thanks Michael
43:45no problem at all
43:47no problem
43:47and actually give them
43:48a good long-term prognosis
43:50and future life
43:52it's really a nice feeling
43:53take care
43:54thanks
43:54bye bye
43:55bye bye
43:55bye bye bye
43:55bye bye bye
43:55bye bye bye
43:55bye bye bye
43:57bye bye bye bye
43:58bye bye bye bye
43:58bye bye bye bye
44:33And if you or someone you know has been affected by the issues covered tonight,
44:38find information and support at channel5.com slash helplines.
44:43Tomorrow, every second counts when breath is short and chest pain kicks in.
44:48It's blue lights to casualty 24-7, brand new at 8.
44:52Next evening, establishing a cause of death.
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