Leucotome
Leucotome
A leucotome is a surgical instrument used in the procedure of lobotomy, a form of psychosurgery that involves severing connections in the brain's prefrontal cortex. The leucotome was specifically designed to cut brain tissue and was a critical tool in the development and practice of lobotomies during the mid-20th century.
History
The leucotome was first introduced by António Egas Moniz, a Portuguese neurologist who is often credited with pioneering the lobotomy procedure. Moniz developed the leucotome to perform what he called a "leucotomy," which involved making small lesions in the white matter of the brain. This procedure was later refined and popularized in the United States by Walter Freeman and James W. Watts, who developed the transorbital lobotomy technique.
Design and Function
The original leucotome designed by Moniz was a simple, hand-held instrument with a retractable wire loop that could be extended to cut brain tissue. The instrument was inserted into the brain through small holes drilled in the skull, and the wire loop was used to sever connections in the prefrontal cortex. Later versions of the leucotome included more sophisticated designs, such as the Freeman-Watts leucotome, which featured a rotating blade for more precise cuts.
Procedure
In a typical lobotomy procedure using a leucotome, the patient would be anesthetized, and small holes would be drilled into the skull. The leucotome would then be inserted into the brain, and the surgeon would manipulate the instrument to create lesions in the prefrontal cortex. The goal of the procedure was to alleviate symptoms of severe mental illness, such as schizophrenia, depression, and obsessive-compulsive disorder.
Controversy and Decline
The use of the leucotome and the practice of lobotomy became highly controversial due to the severe and often debilitating side effects experienced by many patients. These side effects included cognitive impairment, personality changes, and in some cases, death. The development of antipsychotic medications in the 1950s and 1960s led to a decline in the use of lobotomy and the leucotome, as these medications provided a less invasive and more effective treatment for mental illness.
Legacy
While the leucotome and the practice of lobotomy are largely viewed negatively today, they played a significant role in the history of neurosurgery and the treatment of mental illness. The development of the leucotome and the techniques associated with its use contributed to a greater understanding of the brain and its functions, paving the way for more advanced and humane treatments.
See Also
- Lobotomy
 - Psychosurgery
 - António Egas Moniz
 - Walter Freeman
 - Transorbital lobotomy
 - Neurosurgery
 - Mental illness
 
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Contributors: Prab R. Tumpati, MD