James remained awake during the four most critical hours of the six-hour surgery because doctors needed to test and verify his vision while the operation was progressing.

His condition, called a venous aneurysm, was produced when a blister, about 0.5 inch (13 millimeter) high and with a 0.04-inch (1-millimeter) thick wall, appeared on a major vein in his brain, specifically, behind his right eye. If the aneurysm had ruptured, it would have killed him.

An aneurysm is a localized bulge of a blood vessel caused by a failing or weakening  of the vessel wall or by various diseases.

The surgical team was composed of three neurosurgeons, one plastic surgeon, two anesthetists, and four nurses. They entered the patient’s brain through a tiny opening in the frontal bone above the eyes.

Dr. Khurana said of the operation, "As far as I'm aware reading the literature, this kind of thing done as a package has never been done before.”  [AFP]

Khurana made such comments after surgery was performed on a patient who remained awake during most of the surgery. Khurana also commented on the amount of high-technology equipment used for the operation: such as a ultrasound probe to measure blood flow, eyepieces with multi-dimensional MRI (magnetic resonance imaging) scans to display the head, and virtual reality software to create a three-dimensional image of the brain.

The surgical team also used the keyhole approach to surgery—specifically, a small 0.6-inch (15-millimeter) incision was made in the patient’s forehead in order to enter the brain.

The surgery was successful, with the patient leaving the hospital after a few days. A follow-up examination showed no sign of the aneurysm, and Mr. James, the patient, was recovering quickly.

[Author's note: Per the first comment, I did add the 1st "high-tech" brain surgery with the patient conscious to the title as the doctor's claim.]

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