Medics have performed a UK-first operation to remove a previously inoperable brain tumour using keyhole surgery through a patient’s eye socket.
Ruvimbo Kaviya, 40, became the first person in the UK to have a brain tumour removed from the cavernous sinus, the space beneath the brain and behind the eyes, via the pioneering new type of surgery.
Many tumours in this part of the brain were previously considered inoperable, or required complex surgery that involved removing a large part of the skull and moving the brain, which can lead to complications such as seizures.
Surgeons from Leeds teaching hospitals NHS trust were the first in the UK to use the endoscopic trans-orbital approach in an operation, which took just three hours. Kaviya, a nurse in Leeds, was up and walking about later the same day.
The surgery has now been performed multiple times, giving hope to UK patients whose cancers were previously seen as inoperable.
Kaviya was diagnosed with a meningioma in 2023, after suffering from severe headaches, and a second meningioma was found in October that year.
“It was the first time they were doing the procedure. I had no option to agree because the pain was just too much – I didn’t even think about it being the first time, all I needed was for it to be removed,” said Kaviya, who is now back working as a stroke rehabilitation nurse in Leeds.
“I had some headaches, which felt like an electric shock on my face. I couldn’t even touch my skin on the face, I couldn’t eat, I couldn’t brush my teeth, it was really terrible.”
Medics at Leeds consulted experts in Spain who said she would be a good candidate for this new surgery and the operation was performed in February 2024.
Kaviya, who has three children, said her family were sceptical about the procedure, and she was told there was risk involved.
“I just told them that ‘I just have to do this – it’s either I do it or it keeps growing, and maybe I will die. There’s a first time to everything. So you never know, this might be the best chance for me to have it’. And it was,” she said.
She added that she was home from hospital within days, and other than a “really tiny” scar, and double vision for about three months, she has had no side effects.
Experts at the hospital practised the surgery multiple times, first using 3D models of Kaviya’s head and then in a cadaver lab.
Asim Sheikh, a neurosurgeon, told the PA news agency: “This way, we’re not even sort of touching the brain. It’s a hard to reach area, and this allows a direct access without any compromise of pressure on the brain.”
His colleague Jiten Parmar, a maxillofacial surgeon, devised a technique where a little part of the outside wall of the eye socket was cut to allow more access.
“We innovated a new technique, which I think is unique to Leeds, to make the operation much easier,” he said. “It was so well rehearsed, it felt like we’d done it 100 times before – and that’s the way it should be when using a new technique.”
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