Surgery Without the Surgery?
September 08, 2019
A new cutting-edge brain surgery that doesn't require cutting?
Researchers at St. Luke's Hospital in Boise say it's possible; and not only is it possible - it's successful.
The new technology, known as augmented-reality brain surgery, gives surgeons a unique view of the brain that can allow them to see deeper into the structure. The research team behind the project says one of its primary benefits is reducing the chance of error.
Brain surgery is serious business. Like any surgical procedure, the chance of error or complication exists, which could have severe lifelong implications for the patient.
If the brain is injured during surgery, body processes and systems can be compromised; memory and cognition can be impacted, and the potential for paralysis goes up.
The St. Luke's neurosurgery team used their new technology on a patient experiencing a rupture of an arteriovenous malformation (AVM), a twisted tangle of abnormal blood vessels within the brain.
When the patient's AVM ruptured, he was flown to St. Luke's and prepped for a brain procedure known as embolization, a procedure in which a needle is inserted into the radial artery at the wrist, and a catheter is threaded to the brain.
Once in the brain, glue, tiny coils, or other material is inserted through the catheter to stop the blood vessels of the AVM from bleeding.
But it's a temporary fix. Surgical removal or resectioning of the blood vessels to treat an AVM is the next step if the AVM bleeding cannot be stopped or the blood vessel tangle is in an area that cannot be easily reached.
During the surgical procedure, the neurosurgeon removes a section of the skull to access the abnormal mass of arteries and veins. The AVM is sealed off with clamps and is carefully removed. After excision, the skull bone is reattached, and the incisions in the scalp are closed.
Recovering from the procedure can take weeks and have significant risks.
This is where the Idaho researchers and their augmented-reality technology came in.
With their new technology, the researchers were able to locate the exact site of the AVM without making a single incision. Going through the wrist catheter and using an operating microscope and digital imaging, the surgeon was able to see the AVM and resection it with the help of a real-time headset display.
The technology is a game changer, and the St. Luke's team believes it can make brain surgery safer.
"Making the brain surgery safer is critical for improving patient outcomes," said Dr. Faisal Jahangiri, CNIM, D. ABNM, FASNM, of AXIS Neuromonitoring in Richardson, Texas.
He should know. His work is dedicated to improving patient outcomes through the use of Intraoperative Neurophysiological Monitoring, or IONM.
"Surgical neuromonitoring is an emerging technology to monitor the impact of surgery on a patient in the real-time, while the surgery is happening," Jahangiri said.
Monitoring patients during surgery for changes in nervous tissue integrity allows our surgeons to make adjustments or corrections to prevent lifelong side effects like paralysis, visual, hearing or memory loss or loss of bladder or bowel control.
"Adding intraoperative neuromonitoring (IONM) to the operating room advances patients' safety - especially for spine and brain procedures," Jahangiri said.
Source: KTVB.com. New brain surgery technology now used in Idaho. 20 June 2019.
