South Nassau Communities Hospital

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South Nassau in the Community

12/13/2007

OR “Navigation System” Increases Precision of Brain Surgery


The operating room at South Nassau Communities Hospital is equipped with a powerful computer system that combines infrared cameras and three-dimensional body imaging to produce a precise real-time “road map” that neurosurgeons use as a guide to help them complete complex brain surgery to remove tumors and repair other life-threatening conditions.

The system, BrainLab®, is a central platform for 3-D image-guided surgery, consisting of powerful computer hardware, touch screen monitors and two high-definition video cameras that emit infrared signals to determine the patient’s position as well as the position of surgical instruments as they relate to the real-time, diagnostic images of the operative site.

Prior to an operation employing BrainLab technology, surgeons place reflective markers on the patient’s body. The markers are picked up by infrared cameras that transmit data to the 3D navigation system, which then produces three-dimensional images of the patient’s anatomy. “Similar to a pilot using radar, the surgeon uses the BrainLab imaging to assist in planning the incision with greater precision and in finding ideal access to the tumor,” said Michael Brisman, MD, Chief of Neuro-Oncology and Co-Medical Director of South Nassau’s Long Island Gamma Knife®. “The imaging also serves as a guide for the surgeons and allows them to follow the movements of their surgical instruments on the computer screen as they operate.” “The system’s imaging also enables the surgeon to see beyond the surgical field. As a result, surgeons have safer and less invasive access to brain tumors, vascular abnormalities, and other intra-cranial targets,” added Dr. Lee Tessler, MD, a neurosurgeon at South Nassau.

A recently completed study involving 420 surgical cases of various types of brain tumors demonstrated the effectiveness of the system. The system was utilized to make bone flaps (the surgical removal of part of the skull to expose the brain) to detect critically located, deep-seated skull-base and skull bone tumors and to operate on faintly visible brain lesions, such as gliomas (a type of primary central nervous system tumor that come from glial cells, the most abundant, supportive cell in the central nervous system, which includes the brain and spinal cord). In each surgical case, the system not only revealed benefits for operative planning and surgical safety, visualization of the anatomy and surgical site, and determining the exact location of the lesion, but also greatly enhanced the surgeons’ confidence.

Brain tumors are one of the most dangerous disorders and result in roughly 13,100 deaths in the United States, according to 2003 statistics from the American Cancer Society. According to a Central Brain Tumor Registry of the United States (CBTRUS) report, nearly 360,000 people are living with a diagnosis of a brain tumor in the United States and approximately 39,000 new cases of primary brain tumors are diagnosed every year.

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