Tumour deep inside woman’s head removed through eye socket in UK-first operation

A tumour inside a woman’s head was removed using keyhole surgery through her eye socket for the first time ever in the UK.

Ruvimbo Kaviya had a meningioma sitting in the space beneath the brain and behind her eyes that would usually have been considered inoperable.

When tumours have been removed from that area of the head it has required complex surgery that involves taking off a large part of the skull and moving the brain to access the cancer.

This method comes with a high level of risk and can lead to serious complications, including seizures.

But it’s been revealed surgeons from Leeds Teaching Hospitals NHS Trust managed to successfully extract Ms Kaviya’s tumour using key-hole surgery through one of her eye sockets.

Medics practiced the technique – known as a endoscopic trans-orbital approach several times initially using 3D models of Ms Kaviya’s head and then on cadavers.

She has been left with just a tiny scar near her left eye.

Surgeons have now performed similar surgeries, giving hope to UK patients whose cancers were previously seen as inoperable.

Neurosurgeon Asim Sheikh, said: ‘There’s been a move towards minimally invasive techniques over the last few years or so, with the advancement of technology, tools, 3D innovation, it is now possible to do the procedures with less morbidity, and that means the patients recover quicker and better.’

He said traditional methods to reach the area where the tumour was situated required ‘pressing on quite a lot of brain’.

‘So if you press on it too much, or retract it, or try and move it apart, then it can lead to patients having seizures afterwards,’ Mr Sheikh explained.

‘Whereas 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 for the endoscope.

Mr Parmar said that before this new technique, the area that needed to be operated on was ‘difficult to get to from the outside without taking off most of the skull plate,’ which in itself can cause some quite serious damage.

‘Going through the eye socket gets into the same area and it’s a way more elegant approach,’ he said, adding that it disturbs fewer nerves.

James Robins, fellow in neurosurgery, added: ‘This is major surgery through minimally invasive techniques – so it’s still a massive surgery.

‘Using the endoscope, it’s about five millimetres in diameter, we only need a very small space in order to gently displace the eye to one side to get to the back of the eye socket, removing a small, tailored amount of bone.’

From there the tumour can be carefully taken out.

Ms Kaviya said the tumour was causing such severe headaches that when she was offered the surgery she didn’t care it would be the first time such a procedure was happening in the UK.

‘I had some headaches which felt like an electric shock on my face,” she said.

‘I couldn’t even touch my skin on the face, I couldn’t eat, I couldn’t brush my teeth, it was really terrible.

‘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.’

Ms Kaviya, whose three children are eight, 12 and 13, said her family were ‘sceptical’ about the procedure.

‘But I just, I just told them that “I just have to do this – it’s either I do it or it, it keeps growing, and maybe I will die. Who knows?

‘”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.’

The now 40-year-old underwent the operation February 2024.

Although she was home ‘in days’ – sooner than expected – she needed three months off work, during which time she struggled with’double vision’.

However, she’s now back caring for patients in Leeds needing stroke rehabilitation.

Ms Kaviya said she has been left with a ‘really tiny’ scar, adding: ‘If you don’t really look closely, you won’t be able to see.’

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