In this article, we describe the first author’s personal experiences from the past 25 years, illustrating how Jesus has guided scientific neurosurgical innovations that he received in deep prayer since his conversion. In this summary, we outline three important innovations from the last 25 years that could fundamentally change the course of neurosurgery in the treatment of the most severe cranial and spinal injuries, micro-neurosurgery, and neurosurgical manual training. These have been partly published and received awards, but their common origin-deep dialogue with Jesus-it has not yet been described in a summary scientific publication because science is still reluctant to accept that it belongs to the created world. Science cannot create; it can only recognize and describe the laws created by nature which created by God. A good example of this is vitamin C, which has been present in the living world since the beginning, but it was only discovered in the last century, just like magnetic resonance, which allowed physics to realize one of modern medicine's most important diagnostic procedures, the MRI.

METHOD

(Described by first author spiritual experience)

Twenty-six years ago, I returned to the pure-hearted faith of my childhood and recognized God dwelling within me-the Father, the Son, and the Holy Spirit. Prayer to them became part of my daily life. I completed two university degrees, but until the age of 42, I had no creative scientific ideas in neurosurgery. I was a believer in a Sunday-only manner, but eventually, I abandoned even that and did not concern myself with Jesus Christ.

After my conversion, I became a regularly praying doctor, and during surgeries, I received the following scientific insights into truths that had been hidden from neurosurgery until then. There is nothing extraordinary in this, as when we walk a deep spiritual path, for example in prayer, we inevitably encounter a repository of truths, including those related to our own field of science, in this case, the science of neurosurgery. Here we can recognize those scientific truths that have always existed but had not yet been identified, thought of, or applied by anyone, nor published in scientific journals. Naturally, we have an advantage in those areas we are already involved in and have experience with.

RESULTS

1. Severe Traumatic Brain Swelling: Hundreds of thousands of people, especially young individuals, still die from this condition each year. In the surgical treatment of this, the decompressive craniectomy described 120 years ago but the results were not promising. Only the 5-10 % of neurosurgeons applied it routinely. The main problem was the immediate occlusion of bridging veins at the sharp Dural and bone edge. The new technique was born during the prayer of Rosary called vascular tunnel technique, by which the venous occlusion practically disappeared and significantly reduced mortality rates and increased the rate of functional survival [1] (Figures 1A-1D).

Innovation born from prayer was applied to severe cervical and thoracic spinal injuries, where there is no bony stenosis or luxation, but only spinal cord contusion, leading to consequent spinal cord swelling. The same complication can arise as in traumatic brain swelling. Attempts were made with decompressive durotomy, but the expected success was not achieved. Through the study of several cases, we realized that the decompressive durotomy never had sufficient radicality. If even a single thin section remains, the compressive force that strangles the swelling spinal cord persists. Therefore, it is necessary to extend at least one segment above and below the injured segment to allow room for expansion, considering potential ascending or descending swelling. Clinical assessment is complicated by the fact that, based on the developed spinal shock, it can be easily concluded that there is no stenosis yet, and no significant instability that would warrant surgery; the clinical presentation resembles that of a complete transverse lesion, leading the neurosurgeon to decide against surgery. Ultimately, the spinal shock conceals the possibility of the spinal cord recovering, as the developing swelling, particularly in the area of anatomical intumescences, indeed, completes the transverse lesion that was not yet complete—only the spinal shock symptomatically 'blinded' the examiner. Therefore, it is more appropriate to base decisions on the MRI findings. In the case we are presenting, this is exactly what happened. On the second day after decompression, the cervical spinal cord began to 'awaken,' and three weeks later, the patient started to walk with assistance. Finally, within six months, the patient was able to walk independently with an intact autonomic This case, which came to light during prayer, revealed this previously unrecognized possibility." Function (Figures 2A-2D). Important severe case (Figures 3A & 3B) which came to light during prayer, revealed this previously unrecognized possibility. A 14-year-old boy showed a complete cervical spinal cord injury at the CV level after diving into shallow water. Twenty-four hours after Dural decompression, there was minimal motor response in the limbs, but it disappeared within another 24 h, once again presenting a complete transverse lesion, which persisted. The next MRI showed that the spinal cord swelling had ascended above the level of decompression, and the spinal cord was compressed at the upper level of the decompression. If we had gone higher, the patient might have had a chance. Unfortunately, unlike decompressive craniectomy, this procedure is still in the 'not recommended' category. This is very difficult to model in animal experiments, but it is necessary to do so in order to advance the case with rational consideration, just as the case of decompressive craniectomy was advanced through proofs on fresh cadavers. Unfortunately, in life-threatening situations, the neurosurgical guidelines do not really take into consideration. In life-threatening illness, the scientific rationale for the treatment must be sufficiently strong that a positive result would be widely accepted” (Figures 2A-3B).

2. Increasing the Effectiveness of Cerebral Microvascular Sutures or Micro Anastomoses Anywhere: Reducing reclusion has always been a goal of vascular micro-neurosurgery. One of the obstacles to this is the physiological hand tremor, which the surgeon tries to minimize. With the new technique, also conceived during Rosary prayer, we achieved robotic precision with a deviation of 0.1-0.2 mm, enabling secure anastomosis of vessels as small as 0.4 mm in diameter (Figures 4A-4D). In the middle up the results of tremorometry. Right side the fingertip support reduces the tremor to 0,1-0,2 mm. The totally “quiet hand” brought further advantages. The exclusion time in the course of cerebrovascular anastomosis (bypass surgery) decreased from 15-20 min (depends on microsurgeon ability) decreased below 7 min. To use straight micro needle also helps 2 more minutes reduction as the fresh (more than 100 times) cadaver practice and living operations (3 times until now) showed us. Non-occlusive micro bypass available by the radical physiological tremor reduction (Figures 5A & 5B) In different microsurgical procedures (Figures 6A-6D) from other medical field the use of fingertip support technique could also be useful (Courses available csokaya@gmail.com).

3. A New Practical Training Method: This could bring significant advances in other surgical fields as well. It essentially brings back a practice from the time of Leonardo da Vinci and Michelangelo in a more advanced form. Back then, even artists practiced in dissection rooms, not just doctors. Since the middle of the last century, this has gone out of fashion, replaced by practicing on plastic models, workshops on preserved anatomical cadavers, or virtual reality training. Naturally, practicing on living beings, particularly in microscopic surgeries like neurosurgery, where the assistant doesn’t perform substantial tasks, leads to compromised practical training. When they eventually begin working as specialists, the errors in handling nerve elements cannot be corrected, similar to the irreparable mistakes in coronary sutures in cardiac surgery. The new training innovation involves daily short practice on fresh cadavers, like the daily short fast training in sports. Other main advantage of daily fresh cadaver practice to modelize the new innovations like the vascular tunnel method were to prove scientific evidence of new technique (Figures 7A-7D). Model of vascular tunnel technique. The high ICP (30mmHg) was created by inflating of balloon which was placed in ventricles (Figures 3A-3C). The venous circulation was modelized by irrigation of saline. The tunnel at 35mmHg ICP prove the free circulation at the sharp Dural and bone edge (Figure 3D). Similarly, to the vascular tunnel method, we were able to demonstrate using a fresh cadaver model that bilateral decompressive craniectomy (DC) creates a significantly more advantageous situation for brainstem movement than bifrontal craniectomy. In bifrontal craniectomy, the dilation is not parallel to the course of the brainstem but perpendicular, so that the pons and the blood vessels running along its anterior surface are compressed by moving forward against the clivus, which leads to circulatory compression and damage to the brainstem. In bilateral DC, the expansion is axially parallel to the course of the brainstem. Based on the recent cadaver model, the use of the latter method is preferable for the traumatized brain. At bifrontal craniectomy the direction of protrusion of the brain stem (Figure 8).

Since this can be done within the scope of regular hospital autopsies, no special permission is needed for these practice surgeries. The legitimacy of autopsies has been established for centuries and is embedded in hospital regulations, which the patient signs upon admission (Figure 9).

DISCUSSION AND CONCLUSION

The most important bioethical rule in life-threatening situations is: "In life-threatening illness, the scientific rationale for the treatment must be sufficiently strong that a positive result would be widely accepted." (Warren T. Reich, Encyclopedia of Bioethics, page 2276) The first method conceived in Rosary prayer brought significant progress with the vascular tunnel technique developed during Rosary prayer. The method's global adoption is indicated by awards from world congresses (EMN Moscow 2001, ICRAN Bali 2002) and high international citations (more than 250). Most importantly, the mortality rate nearly halved, and functional survival tripled [1,2]. The second ultra-microsurgical method conceived also in Rosary prayer, which achieves robotic hand precision (3), has also been spreading, with international microvascular courses held five times so far. The third thought, [4-6] conceived in prayer, is the most challenging to implement. There is significant resistance to surgeries on fresh cadavers. This is a great surprise to the authors, especially in the country of Ignác Semmelweis, but this too must be accepted. In one hospital, where the neurosurgical department's standard of care could be said to have "lived off" this practice, anatomical practices were banned due to journalistic and medical!!! intrigues. The first two methods were proven on fresh cadavers, but I would highlight the separation of craniopagus twins (2019), during which we neurosurgeons applied five ideas received in Jesus' prayer, and only through this was success possible [7]. There was such significant opposition that Christian brothers who did not accept the role of. Jesus’ prayer tried to undermine the results with unprofessional interference, but God performed a miracle-the child survived, one in good condition (GOS 5), the other, unfortunately, less. (GOS 3) [7]. Short film available about the separation: https://kosmospublishers.com/wp-content/uploads/2024/01/Jesus-Prayers-Applied-in-Separation-of-Craniopagus-Twins_1.mp4. In summary, with the above examples, we tried to prove that during prayer to the Trinity God, scientific truths do indeed emerge from the depths of the soul, bringing significant advancements in patient recovery and solving difficult medical challenges. I hope we strengthened the deep connection between the science and faith which is a matter of debate since centuries [8,9].

ACKNOWLEDGEMENTS

Specifically, we would like to express our gratitude first of all to:

Balázs SándorMuhari-Pap (painter) for the medical illustrations

Enikő Czirják Chief (chief scrub nurse)

János Szász (film director) leading the film footage from 4 camera positions.

Zoltán Kiss (film sculptor and model maker) for making doll models which was one of the main bases of practice and analytic way of thinking

József Pejkó (autopsy assistant) helpingus during the daily inductive fresh cadaver excersises

Márta Jackel MD. (Chief of Pathology Dept.) for providing background for daily cadaveric practice

Prof. Miklós Kellermayer for specific support in topic faith and science

Fr.† Péter Mustó SJ, Fr.†Ferenc Jálics SJ, Fr,Szabolcs Sajgó (SJ) for giving specific moral support by teaching us the contemplative prayer of Jesus. The nuances and analysis of complications described in the paper were born during these prayers.

Members from different religions and cultures as coauthors and thousands of spiritual and monetary donors