Playing the violin, watching cartoons and performing crossword puzzles: these are just some of the activities that patients performed while operating on the brain under the guidance of Robert Trignani.
Trignani, head of neurosurgery at Riuniti Hospital in Ancona, Italy, was already known for his “vigilant surgery” techniques, which he has used approximately 70 times in recent years. But on the new ground, it started in June this year when the 60-year-old was preparing stuffed olives while removing a tumor from her left temporal lobe.
It was not an easy feat – preparing olives, ie. Known as Ascoli olives, a specialty of the Marche region, they are prepared in a complex process in which green olives are extracted pitted, then wrapped in dried flesh, coated with breadcrumbs and fried. The woman, a former cook, made 90 of them in less than an hour.
In the meantime, Trignani acted. Vigilant surgery allows the surgeon to avoid damaging healthy tissue while treating the areas of the brain responsible for speech, vision and movement. In the case of the olive grower, Trignani and his team were able to remove the tumor from the areas of the brain that control speech, as well as from the right side of the body.
“We studied the patient’s life, her routines and preferred activities to see if there was anything that could be useful for her course of therapy,” Trignani told the Guardian. “In this case, the woman was a good cook and, above all, she worked in an area known for Ascoli olives. We knew that you need significant manual skill to prepare such olives, so we thought that guiding olives to it would be a way to track the area of the brain we need to work on. “
The operation went according to plan, and the woman, who left the hospital after a few days, is recovering well.
Trignani’s unusual ideas are not limited to conscious operation. One brain came to him this summer after attending a concert by Emilian Tos, a musician and molecular biologist who claims to play music on a soothing frequency. “Listening to his music, I thought: what would happen if we brought Emilian Tos’s grand piano into the operating room?” Trignani said.
Toso agreed to play, and in November, a piano was introduced into the operating room for a four-hour operation to remove a tumor from the spinal cord of a ten-year-old. Although the patient was under general anesthesia, Trignani said an encephalogram that tracks the electrical activity of the brain suggests the boy is perceiving music. When the musical notes were interrupted, he said, the patterns of the brain changed.
Another of Trignani’s most modern surgeries was on a woman who was blind in one eye and developed a tumor in an area of the brain that controlled vision in the other eye. The operation took place last year on December 13, on the holiday of Santa Lucia or the “festival of light” in Italy. While Trignani underwent surgery to remove the tumor, the woman did eye tests on a computer screen.
“If we had damaged the area near the healthy eye, it would have gone blind,” Trignani said. “So we decided to do an awake operation on her – there were about five or six such cases in the world. She wrote to me a few days ago, on December 13th  approached saying that Santa Lucia had protected her because she could still see well in that eye. “
Trignani said the most satisfying part of his role in awake surgeries was the human connection during surgeries and the patient’s reactions afterwards. “When you see a patient doing well and having a sense of gratitude, this is the most beautiful part,” he said. “Those who become doctors do it while they want to see patients do well – this mission makes you want to eradicate human suffering.”