NTB provincial hospital performs first STA–MCA brain bypass operations

Mataram — West Nusa Tenggara Provincial Hospital (RSUD Provinsi NTB) has carried out its first Superficial Temporal Artery to Middle Cerebral Artery (STA–MCA) brain bypass procedures, treating two patients during a proctorship programme on 11–12 September 2026, according to hospital and media reports.

The microsurgical bypass connects a blood vessel outside the skull to one inside the brain to improve cerebral blood flow in patients whose brain arteries have narrowed or circulation is impaired, the Health Ministry’s Directorate General of Advanced Health Services explained.

The inaugural operations were conducted under a brain bypass proctorship involving RSUD Provinsi NTB and specialist teams from Prof. Dr. Mahar Mardjono National Brain Centre Hospital (RS PON) in Jakarta and Prof. Dr. I.G.N.G. Ngoerah Hospital in Bali.

Two patients treated during proctorship

Local coverage of the programme states that the first patient was a child with long-standing neurological symptoms including weakness on one side of the body and speech and cognitive difficulties, with imaging showing narrowed brain blood vessels and a diagnosis consistent with Moyamoya disease.

The STA–MCA bypass was selected to provide an alternative route for blood flow to reduce the risk of insufficient oxygen supply to the brain and recurrent stroke, according to explanations from clinical staff cited in regional media.

The second patient was an adult with a history of ischaemic stroke, limb weakness and speech impairment, for whom examinations showed impaired cerebral blood supply and led doctors to choose bypass surgery to improve circulation and lower the risk of another stroke event.

Hospital and media reports state that both operations were completed as planned and described as successful by officials, but they do not provide detailed information on postoperative recovery, neurological status or the timing of discharge for either patient.

NTB joins limited group providing STA–MCA bypass

Obrin Parulian, director of clinical services at the Directorate General of Advanced Health Services in the Health Ministry, said the new capability places West Nusa Tenggara among a limited number of provinces able to offer the complex neurosurgical service.

He stated that out of 38 provinces nationwide, 11 currently provide STA–MCA bypass services, and that sustaining the service independently would bring a hospital closer to the level of a referral centre supporting other facilities.

The Health Ministry is promoting wider access to priority advanced medical services and expects each province to have at least one government hospital capable of performing brain bypass procedures, supported by appropriate operating microscopes, microsurgical equipment and ongoing skills development through networks of referral hospitals.

West Nusa Tenggara’s regional secretary, Abdul Chair, said the new service reflects efforts to reduce dependence on referrals outside the province and must combine investment in medical technology with the development of specialist human resources, noting that the proctorship covered preparation, clinical decision-making and postoperative monitoring as well as the surgery itself.

Capacity still being built

Regional reports describe the 11–12 September proctorship as the development phase for RSUD Provinsi NTB’s first STA–MCA bypass operations and emphasise that continued mentoring from referral hospitals remains important for complex stroke care.

The hospital’s participation in national referral networks led by RS PON in Jakarta and Prof. Dr. I.G.N.G. Ngoerah Hospital in Bali is aligned with Health Ministry policy to distribute advanced neurosurgical services beyond major urban centres.

While officials highlight that patients with complex stroke in West Nusa Tenggara no longer necessarily need to be referred to Bali or Makassar for STA–MCA bypass, they have not yet detailed how frequently the procedure will be offered, which neurosurgeons will lead future cases, or how rapidly the hospital aims to operate independently of visiting proctors.

Sources

• Tribunnews Lombok regional report on RSUD NTB brain bypass
• Pantau.com national report on RSUD NTB bypass surgery
• RRI Mataram report on NTB becoming 11th province for bypass stroke care
• Bisnis.com Bali article on RSUD NTB complex neurosurgery services
• Indonesian Health Ministry Directorate General of Advanced Health Services decision document