Resective surgery is the most common form of surgical treatment for uncontrolled seizures. So what is resective surgery? Resective surgery is a type of epilepsy operation in which the area of the brain responsible for seizures is surgically removed. The brain is comprised of four lobes called the frontal, temporal, parietal, and occipital lobes. Seizures most often arise from one or both temporal lobes. In the deep front part of the temporal lobes are located the most seizure-prone structures in the brain: The hippocampus, which is Greek for "seahorse," and the amygdala, which means "almond." Because of this, temporal lobectomy is the most common- most successful-type of resective surgery. Access to the deep temporal lobe can be achieved in two ways. The conventional approach involves removing an inch and a half from the tip of the temporal lobe to provide access. The second involves cutting into the outer brain and opening a window from the side. However it is accessed, the hippocampus, amygdala and surrounding brain are removed by a combination of cutting and suction, since brain tissue is soft. All bleeding is carefully controlled during surgery. The surgery does not remove a tiny piece of brain, but rather a sizable part of one lobe. After the removal of the temporal lobe tissue is complete, the bone is replaced and secured to the skull, and the scalp is sutured. Whenever possible, the surgeon uses incisions behind the hair line for the best possible cosmetic results. Patients then move to a recovery room or intensive care unit. A few days post-surgery, though, most move to a normal room and are eating and walking. Post-operative nausea and headache are common, so patients receive medicines for these conditions-and possibly seizure medications as well-intravenously for six to 48 hours. Hospitalization for temporal lobectomy typically lasts from four to six days for a one-stage surgery, and nine to 14 days if a two-stage surgery is completed. Then, patients take it easy around the house for a week, at which point the surgical stitches or staples are removed. Vigorous activity should be avoided for a month or two, but a patient can generally return to work within one to three months. Patients often ask whether the part of the brain which is removed ever grows back. It does not. Immediately following surgery, the fluid that surrounds the brain fills in the empty area. Another common question is whether the surgery creates a scar that will produce seizures. Usually it does not, because the surgical scar is "clean" and does not irritate adjacent parts of the brain. This is like the difference between a plastic surgery scar and a scar from a bad accident. When a patient has undergone resective surgery, most doctors will keep that patient on seizure medicines for at least several years. Sometimes, medication is necessary for life, although the dosage might be reduced. While resective surgery can be quite effective, it is not for everyone and is always a patient's personal choice! If you think you might be a good candidate for surgery, discuss your options with your doctor.