Posted on: Fri 28-07-2023

 

As more than 17 children have successful endoscopic neurosurgeries

 

It was jubilation galore at the University of Nigeria Teaching Hospital (UNTH), Ituku Ozalla, Enugu State, a few days ago as no fewer than 17 children with hydrocephalus went through successful endoscopic neurosurgeries.

 

The feat was achieved during the first Enugu Endoscopic Third Ventriculostomy + Choroid Plexus Coagulation (ETV/CPC) collaboration between the UNTH and NeuroKids Foundation, United States of America (USA), which held from July 17 to 21.

 

The mood of parents of the children (patients) and members of their families was a clear evidence of restoration of peace and joy to them and their families following their kids’ successful endoscopic neurosurgery. And being the first time such was being done in the South East region of the country, it also excited the management of UNTH and the team of experts.

 

Hydrocephalus and neural tube defects (specifically, spina bifida) are said to be the two most common neurosurgical conditions in children. Untreated, both are potentially fatal and survivors are profoundly disabled for life. Both are vastly more common in lower-income countries. Fortunately, both are preventable.

 

Children with hydrocephalus have excessive brain fluids that make them experience abnormal growth in parts of their body. It could also be described as a neurological disorder caused by an abnormal buildup of cerebrospinal fluid in the ventricles (cavities) within the brain.

 

Experts say excess fluid could cause ventricles to widen and put harmful pressure on brain tissues in children. In the process, it enlarges their brain and head.

 

Before the surgeries, the UNTH neurosurgery team led by a consultant neurosurgeon and project director of NeuroKids-UNTH collaboration, Prof. Enoch Uche, had been trained by the experts from NeuroKids and was positioned to bring accessible and quality care and treatment to many Nigerian families with children suffering from hydrocephalus and spina bifida.

 

Explaining the new trend in the treatment of hydrocephalus and details of the UNTH collaboration with NeuroKids, Uche disclosed that NeuroKids donated neuroendoscopes  and many other equipment worth over $90,000 to make the project succeed.

 

On hydrocephalus, he said that “these are noticed at birth. Unfortunately, because they didn’t have money they didn’t come for treatment. The current evidence-based treatment of this, which has been demonstrated to be the best form of treatment, is called Endoscopic Third Ventriculostomy + Choroid Plexus Coagulation. This treatment was pioneered by a gentleman from the United States called Prof. Benjamin Warf, who is the head of Congenital Malformations Team at Boston Children’s Hospital in Harvard Medical School, Boston.

 

“Dr. Warf did not stop in pioneering the surgery; he is the chair of NeuroKids Foundation, a team that is devoted to spreading the treatment of hydrocephalus around the world by training and setting up units to conduct these surgeries.

 

“In this collaboration, NeuroKids is equipping UNTH with all these facilities that we are using to do this surgery. We have what we call a neuroendoscope, flexible neuroendoscope that is what we are using to look into the brain of this child, if you look at the monitor you will see; we are into the brain of this child. And what we have done is that rather than do what we used to do before called vetriculoperitoneal shunt, which has a lot of complications. In that surgery what we do is to connect a tube in the brain and then to the peritoneal cavities in the abdomen so that the excess brain fluid can drain into the abdomen.

 

“But that is front with a lot of complications, like infections, seizures and many of these shunts will block overtime and you need to have repeated surgeries. Many of our patients cannot even afford the first surgery let alone repeated surgeries. So, most of them are abandoned and are left to die, some of them are abandoned and are taken to motherless babies home, some of them abandoned and these children die uncared for.

 

“However, UNTH working with NeuroKids is making this surgery and this treatment available in UNTH and surgeries are subsidized by the management of UNTH while NeuroKids has provided both the facilities and some experts. What you have here, these endoscope systems worth tens of millions of naira and NeuroKids has provided it free of charge, not only that, NeuroKids has mobilized a team to come and support us as we do this surgery. That team is led by Dr. Justin Onen, a neurosurgeon who has a lot of experience in doing these surgeries at Mulago Hospital, Uganda. There is also Prof. Femi Bankole from Lagos who is also part of the team.”

 

Expressing joy that the treatment is now available to their patients under the sponsorship of NueroKids, Uche said: “We want to implore the government to come to the aid of patients with hydrocephalus. Because most of them are born by poor families, they are not usually brought for treatment, that’s why you are seeing a five-year-old being brought for treatment for the first time.

 

“If government had made the treatment of hydrocephalus compulsory and free for all Nigerian children, that will be acceptable and a very positive way of saying yes, we want our children to have the best form of health. Not only that, we want the government to partner with UNTH to provide other facilities that are required to make pediatric neurosurgery come to the standard that is acceptable in most of the developed world so that our children would not have to be taken out of Nigeria for treatment.”

 

The Chief Medical Director (CMD) of UNTH, Dr. Obinna Onodugo, who was elated over the new ground his institution has broken the region, expressed joy and satisfaction with the NeuroKids partnership and the adoption of the Endoscopic surgery (Dr. Warf Procedure) by the Neurosurgery Department of the hospital, stressing that it had boosted the efforts of the institution in breaking new grounds.

 

Onodugo commended the government for its efforts in the institution and urged it to see the need to support the hospital in the treatment of Hydrocephalus by subsidizing the cost of the surgery for the children or taking it over entire for the sake of poor masses.

 

The leader of the NeuroKids team, Dr. Justin Onen from Uganda, explained that the NeuroKids was established to help not only the US but the rest of the world to be able to afford neurosurgical care of children, most especially those afflicted by congenital malformation which affect the brain and the rest of the naval system and also those that suffer infection causing Hydrocephalus.

 

“In Africa, we have 40 per cent of the patients developing Hydrocephalus following infection, another 30 per cent hydrocephalus due to congenital malformations and the rest of 30 per cent is associated with spina bifida, patients who have malformations in their spinal cords which also affected their brain as well.

 

“The vast majority of these patients cannot afford even a shunt which is the conventional method that have been used in Africa and rest of the third world. Therefore, the invention of Dr. Warf procedure which is the endoscopic surgery after the bypasses, the usage of a shunt. And actually, you can use one endoscope to treat 500 to 1000 patients before it breaks down. This a much more cost effective method of treating hydrocephalus and NeuroKids is making that more possible by giving equipment cheaply to different centres around Africa and of course, is being subsidized by the governments of those different countries,” he disclosed.

 

Meanwhile, the beneficiaries of the endoscopic neurosurgery who are between the ages of four months and eight years are said to be recuperating after the surgery and their parents have continued to thank and commend UNTH and NeuroKids for coming to their aid and saving them what would have been a lifetime agony.

 

One of them joined in the call on government to make the treatment free saying: “We were able to do the surgery because it was highly subsidized yet over 90 per cent of families who have this case cannot afford it even at this subsidized rate. So, I call on the government to show concern and make the treatment of this hydrocephalus free.”

 

Source: Geoffrey Anyanwu, Sun News

---

---