First time in the world that a piano enters the operating room.

A 10-year-old boy underwent major surgery to the backdrop of a piano played live during the operation at the Salesi hospital in the Italian city of Ancona on 16 November.

The innovative intervention saw molecular biologist and composer-musician Emiliano Toso perform on a grand piano as doctors carried out an operation to remove a tumor from the boy's spinal cord.

Although the boy was under general anesthesia during the four-hour operation, doctors say that at times he hinted at a smile as they worked, reports Italian news agency ANSA.

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The operation was performed by the neurosurgical Roberto Trignani, head of the neurosurgery department of the Ospedali Riuniti in Ancona, with a team of 15 medics.

Observing the encephalogram, which monitors the electrical activity of the brain, Trignani said it was as if the boy "perceived the music because when the notes were interrupted the pattern changed."

It is the first time in the world that a piano has entered an operating theatre, reports ANSA, with Trignani describing it as a thrilling, moving experience.

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"A magical atmosphere of complete harmony was brought into the operating room," he said.

The tumor was completely removed and now doctors are awaiting further tests to see if the boy will require further surgery or not.

As for the little patient, he says: "I'm fine. Did I hear the music? Yes, I heard it."