In simple words: This surgery removes parts of the brain called the hippocampus and amygdala to treat a type of epilepsy. The surgeon makes an opening in the skull, removes the specific brain areas, and then closes the opening.

The procedure involves making an incision in the scalp and skull to access the temporal gyrus. Intraoperative imaging guidance and pre-surgical MRI markings assist in targeting the affected areas within the mesial temporal region. An incision is made in the temporal gyrus, avoiding cortical vessels, and extended towards the temporal horn, exposing the intraventricular anatomy.The parahippocampal gyrus is resected, protecting the internal carotid artery and cranial nerves. The hippocampus and amygdala are mobilized and resected. Hemostasis is achieved, a drain may be placed, and the bone flap is secured back with plates, wires, or sutures before wound closure with a sterile dressing.

Example 1: A patient with medically refractory mesial temporal lobe epilepsy, confirmed by EEG and MRI, undergoes amygdalohippocampectomy to alleviate seizures., A patient with mesial temporal sclerosis causing intractable seizures undergoes this procedure after failing multiple anti-epileptic medications., Following comprehensive evaluation, a patient with epilepsy localized to the hippocampus undergoes amygdalohippocampectomy, aiming to improve quality of life by reducing seizure frequency.

Documentation should include pre-operative evaluations (EEG, MRI), intraoperative findings, surgical technique, tissue removed, hemostasis methods, and post-operative care plan. Medical necessity should be justified with documented evidence of intractable seizures despite appropriate medical management.