United States: In an unusual surgery, a team of doctors in the US successfully removed a brain tumour from a patient while he played a saxophone in the operating room.

When 27-year-old New York-based music teacher Dan Fabbio was diagnosed with a brain tumour, he was concerned about losing not only his livelihood, but also one of his greatest passions in life during the surgery.

The tumour, though not cancerous was located near the part of the brain responsible for music function. So a team of physicians, scientists and a music professor, reported ABC, came up with a novel way to ensure Fabbio did not lose his musical abilities.

‘It was strange because I was lying on my side, and that’s not how you usually play the instrument,’ Fabbio, 27, told the Daily News. ‘And, also, my skull was open.’

Removing a tumour from the brain can have significant consequences depending upon its location, said neurosurgeon Web Pilcher, from Del Monte Institute for Neuroscience at the University of Rochester Medical Centre in the US.

‘Both the tumour itself and the operation to remove it can damage tissue and disrupt communication between different parts of the brain,’ he said.

‘It is, therefore, critical to understand as much as you can about each individual patient before you bring them into the operating room so we can perform the procedure without causing damage to parts of the brain that are important to that person’s life and function,’ he added.

The pair also brought Elizabeth Marvin, a professor of music theory at the university’s Eastman School of Music, on board.

Together, they developed a series of cognitive musical tests that Fabbio could perform while the researchers were scanning his brain. They also made him perform language tasks that required him to identify objects and repeat sentences.

Using this information the research team produced a highly detailed 3D map of Fabbio’s brain - with both the location of the tumour and music function - that would be used to help guide the surgeons in the operating room.

The ability to process and repeat a tune was an important measure, but the team also wanted to know if they were successful in preserving Fabbio’s ability to perform music.

So they decided to bring his saxophone into the operating room and have him play it during the procedure.

The challenge was the pressure caused by the deep breathes required to play long notes on the saxophone could cause the brain, which would be exposed during the procedure, to protrude from his skull.

The doctors ultimately selected a piece - a version of a Korean folk song - that could be modified to be played with shorter and shallower breaths.

During the procedure, the surgical team used the map of Fabbio’s brain to plan the surgery.

During the procedure Fabbio was awake and repeating the humming and language tasks he performed prior to the surgery.

A music professor was present in the operating room and scored Fabbio’s performance to let the surgeons know whether or not they had targeted an area that disrupted music processing and, therefore, should be avoided during the procedure.

Once the tumour had been removed the surgeons gave the go ahead to bring over the saxophone and let Fabbio play.

Fabbio has since completely recovered and returned to teaching music within a few months of his surgery.

Fabbio isn’t the only musician whose abilities assisted surgeons during an important surgery. Professional violinist Roger Frisch played his instrument throughout a procedure to determine the source of tremors in his brain that was affecting his playing.

In 2015, Anthony Kulkamp Dias played a Beatles tune on his guitar during his surgery. It never gets any less astonishing.

In July, a video and photos of 37-year-old Abhishek Prasad strumming the guitar as surgeons at Bengaluru’s Bhagwan Mahaveer Jain Hospital operated on his brain went viral.