Rome — With deft hands, the woman pitted olives, stuffed them with meat and cheese, and then carefully rolled them over bread crumbs. In less than an hour she'd prepared 90 "Ascoli-style" olives, a local specialty of Italy's Marche region. She did it all as surgeons opened her brain and carefully removed a tumor from her left temporal lobe.
While the olive dish may be special, the operation on the 60-year-old patient at a hospital in Ancona, the capital of Italy's Marche region, wasn't novel. Surgeon Roberto Trignani, who runs the Neurosurgery Department, had carried out about 60 similar operations in the last five years, with his patients awake and performing an activity during surgery.
"This allows us to monitor the patient while we are intervening on brain functions, and to calibrate our action," said Trignani.
The activity is chosen based on the part of the brain that is being operated on. In the olive-stuffer's case, it was the area that controls speech, as well as complex movements on the left side of the body.
A previous patient, who needed surgery on the part of the brain that controls vision, was tasked with watching cartoons during the procedure. Others, or played the trombone or the violin.
"For her, we needed rapid hand movements," Trignani told Italian media. After discussing it with the patient, they settled on the preparation of Ascoli-style olives.
Trignani said the patient was also talking during the operation, because the area he was operating on was close to the language center of the brain. She answered questions and even recited some recipes.
Trignani said that when performing awake neurosurgery he's careful to choose an activity familiar to the patient.
"A sick person enters the hospital and finds himself in an unfamiliar environment. With this system, we try and make him feel that he is in a calm and familiar environment. He collaborates, and we work better," explained the neurosurgeon. "This is the humanization of treatment."
The medical team included 11 people, including Trignani and other neurosurgeons, anesthesiologists and nurses. Also present was a psychologist, who had coached the patient for several weeks in advance.
The operation took a total of two and a half hours, and Trignani told Italian media that, "all went well."