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Bristol Neurosurgery 75th Anniversary | Prof Puneet Plaha

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Summary

This on-demand teaching session, relevant to medical professionals, will discuss how the field of NeuroOncology has evolved over time and has incorporated elements of functional neurosurgery. Drawing upon personal anecdotes, Professor Puneet Plaha a former trainee of Oxford and expert in Gliomas, will demonstrate how his research and discussion with key mentors moulded the lessons he learned about understanding how the brain works, performing Lumbar Punctures, and developing the Future GB NH Trial to incorporate functional guided section. This engaging session will cover how technologies such as Neuronavigation, Mixed Reality, and Ultrasound have changed the way brain tumors are treated and ultimately inform professionals in the medical industry.

Description

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**Click Here for Event Booklet**

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Bristol Neurosurgery was founded in 1948, at Frenchay Hospital by the first female neurosurgeon in the world. This year marks the 75th anniversary for Bristol Neurosurgery.

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Prof Puneet Plaha

Consultant Neurosurgeon

Nuffield Department of Clinical

Neurosciences

John Radcliffe University

Hospital, Oxford, UK

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Learning objectives

Learning Objectives:

  1. Recognize the challenges and successes of neurooncologic surgery
  2. Analyze the changing face of glioma surgery
  3. Explain how neurooncology surgery combines aspects of functional neurosurgery and tumor surgery
  4. Demonstrate an understanding of the use of neuravigation and other modern tools in the field of neurooncology
  5. Evaluate the safety and efficacy of functional guided resection of glioblastomas.
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Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

And, and continuing the theme of NeuroOncology. Uh Professor Pony Play, Aha from Oxford, one of our former trainees uh is going to tell us about the changing face of glaucoma surgery. Thank you for the invite. This is an honor to be here. You know, when Mario contacted me six months ago, he said you're coming to this. What would you like to speak on, speak about your memories? And I said, no, no, let's talk about Gliomas because that's my area of research. So I chose this topic and then I put together the talk. I said, no, no, I can't be talking and teaching about Gliomas to the stalwarts in this room. So I changed it to something else. So I do apologize. The title is not what it'll be, but at the end, the story will all add up. So I'll start with a little story next late. So this is 14th of November 2001. And it's, it's a dark night. It's raining at Diwali, which is the Indian Festival of Light. And I've come to French for an essential job. Next side, please. And I meet David Ramnarine who is now a consultant Trinidad and Mr Malcolm is here, was doing the interviews. So there were four jobs and a lot of us turned up and I remember sitting in this room on the other side of French Air which is very cold. The interview started at 34 o'clock and we have four of a lot of us for four jobs. And by about 56, it got cold dust, couple of candidates left and Mister Malcolm said, if you stay here to the end, I'll give you the job. And Dave and I said, what can we are there? So we got the job. So we then became messages together. Next slide. And then 20 years later, Dave and I had a small celebration. That's a whatsapp message you sent me 20 years later saying, hey, do you remember 20 years ago? We got the job on the 14th of November. So that's what that day meant to us. And we still sort of exchange that message every year. Next one. Anyway, we then became registrars and we have a very motive e working at essentials, but very motivated to get a registrar job. But there was one next light, please, Richard Edwards. So, so Richard had had this, he would always next slide, please. He would always do a ward round at 8 p.m. So initially we we knew we would would do it and then it persisted. And someone said, you know what if you keep staying there till 8 p.m. at night, you'll get registered job. And anyway, we ended up getting it. I'm not sure because of this or not. So Richard next one, then I got a registered job 2003 to 2006. I had the fortune of working with the genius. It really was a great time. Next slide, please. There was inspirational research but Thursday night was DBS planning late in the night and we would learn a lot discuss a lot of research. But Thursday would also special next flight, please because you would go down to the raj, which I believe is closed now and they would always be an X slide piece. Next two slides, we would always have a seat marked for us because Steve Gill would also always order Chicken Tikka Masala with Sag Aloo. And I remember one night we were sitting there and the owner who would always come and welcome us said, oh, I've just bought a new BMW and Mr Gill said, oh, that's all my money for all these years from my ticket ticket. So next later anyway, during this research time zone, a inserted took shape PP and stimulation took place. First Tin Man studies took place lots of publication. Next slide please, the resilience of other discussion. So last Sunday, when I was putting some slides together, I went to the study and I took out next slide please. It files which were there and had the topic called how the brain works that Steve Gills handwriting. There. Next slide, please. And you can actually click a few slides and out came hundreds of these papers. Next slides, either Mr Gill's own handwriting with diagrams of how the brain works. So that was years and years of discussion of how the brain works with him. And this is cherished. What it also meant was during those three years, I traveled a lot in conferences and every time I had to go for a conference, Steve would say forget Diane Cornish to authorize that she's here. So it was a good time during those 33 years of research. Next time, please. Next laid. I think that's just next one, please. So then this is my daughter said 19. Now in 2003, my wife was pregnant with her and she went into labor on a Friday. And so we went into South need hospital Friday became Saturday. The nurse said to us, well, so your first child, you know, lots of walking is good. Go for a 10 minute walk. But 10 minutes would become an hour. And then we went into Sunday and I was very stressed and you know, when you come from an Indian family, you have lots of people around you supporting my in laws. Were there, my cousins were there and they were all like, you know, this is the first child, how stressed Benitez. Anyway, the baby came at 4 a.m. on a Sunday Monday morning. And I was relieved. Little. Did they know the reason I was stressed was because Steve Gill would call me at eight o'clock to ask me, what did the next connection within Zona insert and something else? But I didn't tell my in laws and my wife till after my daughter was born. Next one. It's a good love for us in the family. This joke. Next one, please. Anyway, while I was doing research, next one, there were two other Richard Edwards and Christian Nicolina, we used to share an office next to the old library and that area of research was hydrocephalus, NPH, and Hydrocephalus. So we have all these discussion's and at the end of the discussion, they would say, hey, what are you doing tomorrow morning? Can you do a lumbar puncture for us? The lumber infusion test. So I was junior, I was learning, I would go and do it and then, you know, trickle became a flood. I would do lots of them. And Jenny Zachary who don't know whether she is here now would help me do the, do the llama point the next one please. So I did a lot of those. But later in life, I realized that I became a neuro oncology surgeon. Next one, I probably am the only one with a distinction of specialist interest in NPH even now. So, so thank you to both of you. Next one. Then 2005. I started my auntie and training and Katie and I went for the interview together. We got the job and I think there was one job, but then they gave it to both of us. So we joined together and then I worked with some of them. There are others here who I couldn't get their pictures. Next one. But I'll put three up image Sonoda, Nik Patel Disco. Next one please. Next to and Paul Grandi, they were the senior registrar is very helpful and sort of mentored me when I was starting off with my in my training. Next one. Anyway, Katie was the only sort of female, your son. So we looked after Katie very well and this was one of the pictures we had from the group. Next one please. And I worked with a lot of the consultants all here. Uh you know, right from pediatrics to spine NeuroOncology, name it all, everybody was here. However, when I started my training, they said to me, there's one consultant, you got to keep him happy throughout to have a good life. Next lightly. I don't have a picture. Well, Doctor Irvin Brown microbiology actually mentioned him to earlier and, and I will never forget this. I was an essential in 2003 and I was doing a case with Professor Coke. Um and suddenly the theater door opens and you see even brown standing there fully dressed in his suit saying. Oh, neat. And I didn't know who he was. And I said, I don't know who's coming. How dare I'm here with the professor Cocaine himself and process it. To me, my boy, you better describe and go. So, so with Irvine Brown, it was that if intrathecal Vancomycin was not given at eight o'clock, but even five minutes late, he would find you down the long Franci corridors. Um, next one, please. Anyway, the story continues. This is now 2009. I've done Mary said I'm doing my training, but I'm all the way still on the way to become a functional neurosurgeon. Next, next slide, please. Until you know everything. There always a twist in the tale. Next, like my last year of training, I worked with these two gentlemen, Richard Richard David Porter and Mr Nelson. And then I get exposed to skull base surgery and tumor's and Mr Porter says, beneath, you're the sort of Japanese a bit more of a meat on your plate. I said, so then I'm now wavering a little whether I'm gonna be functional neurosurgeon or a tumor surgeon. Next slide, please. So I my finally uh I moved to Oxford, I go to learn endoscopy with Simond cut lip. Keep going next slide, please. Next one, next one. So then this is a picture from my study when I left French. I was given this MRI scan with DBS electrodes within it. So I've sort of framed it and kept in the study. So then the question of how do you combine functional new surgery with tumor surgery? And that's a bit of the last section of the talk on the title I was initially given next slide, please. So we heard about, you know, friendship in the first place with Neuronavigation with a brain tumor surgery we use for it next flight. But the question was, can we change our philosophy from anatomical surgical resection to functional section of tumors? Next slide piece. And that's where the white fiber track to graffiti came in. Next slide please. And the concept then moved towards functional connect tones. Next slide please. Using functional MRI scans. Next slide please. And this is just functional MRI scans. Next slide please and and deficient tracked a graffiti. So finding the collection collector by the Cortical and Subcortical. Next slide, please. Next one. Yeah. And then moving it into the theatre, this recent picture of using mixed reality and theater and and showing patient the scan. Next next next side please. And then applying it as we heard from Paul Grandi within awake surgery. Next slide please. And then using ultrasound as well for live demonstration of tumor removal. Next slide. So functional section of GBM, next light, please. So functional again. So at heart, it remains at the functional neurosurgeon adding a bit to tumor surgery. Next light please. And that came together in an NH trial which we're now running called Future GB, which is functional guided section. And we had it show up the next slide, please. I got this whatsapp messages. One of our trainees met Professor Gill very recently at the meeting and he said, hey, Boss Pravachol talks about highly if you mentioned you want to do functional new study. And I replied, saying I'm still doing functional new study but it brain tumors. So that was all sort of bringing it back together with functional and brain tumor remarrying together. Next light, please. This is just a trial. We can move this forward. Next slide, please. Uh This is just showing some of the work with immunotherapy. I'll just mention, well, last night before I finished next flight. Uh this is where we use new adjuvant immunotherapy for GBM, a new First in man trial. We're starting next light, please. Gentlemen. Thank you very much. Uh You know, I can go on stories on and on with my time and French with an exceptional period. So thank you for the invite. I can't thank anyone enough. Thank you very much. Thank you. Thank you Penny. Next.