Lifewatch: New brain tumor procedure

Reported by Claire Hosmann - email
Posted by Debra Worley - email

(WECT) - A new device as small as a light pen is helping doctors maneuver around fragile parts of the body, including the brain.

Doctors told Stephen Abbott that a tumor the size of a plum was attached to the one of the major veins draining blood from his brain.

Instead of cutting it out with traditional tools, Dr. Andrew Fishman used a pen-shaped carbon dioxide laser.

Originally designed for the Department of Defense to reflect enemy laser beams, the fiber-optic device now allows surgeons to melt and shave off tumors.

"We're really able to almost brush stroke the surface with only a minimal effect on the brain tissue," said Dr. Fishman.

Traditionally, lasers were too bulky for brain surgery and could only be used at straight angles.

Surgeons say the device speeds up surgery, which means smaller incisions and quicker recoveries.

It took about an hour to remove Stephen's entire tumor, and went home just after five days after his surgery.

The laser is also being used in spinal surgery, head and neck procedures, and hearing restoration.

For more information, please contact:
Northwestern Memorial Hospital
Public Relations: Amy Dobrozsi
(312) 926-5900

BACKGROUND: Lasers have been used in surgery for more than 30 years. However, doctors avoided using them in delicate procedures in the brain and spine because they were often too bulky and cumbersome to maneuver. Traditionally, laser energy for neurosurgery could only be delivered through a large articulated arm system and surgeons were limited to "line-of-sight" procedures.

NEW DEVICE: A new CO2 micro-laser is using light energy in place of a cutting tool to remove complicated brain and spine tumors. The technique offers greater precision and efficiency during surgery, reducing the incision size, surgery time and patient recovery period following surgery. he laser allows surgeons to direct CO2 laser energy into deep holes and around blood vessels, other specific nerve structures and the brainstem. It is as light as a pen and fits in the palm of the hand. It is designed for operating near critical structures in the brain and spine, and in place of a scalpel to melt and shave away tumors.

HOW IT WORKS: Water, the primary component of most biological tissues, absorbs CO2 laser energy readily. This ensures minimal thermal spread and makes CO2 laser energy very useful for applications near critical anatomical structures. High absorption of CO2 laser energy in water implies high absorption in tissue. This translates into a superficial effect, as CO2 laser energy is limited in its spread within tissue. The CO2 laser action is limited to the upper layers of tissue when compared to other energy sources and does minimal damage to adjoining tissue. The laser energy also seals small blood vessels as it cuts through the tissue, just like a scalpel. It combines precise cutting, ablation and microvascular coagulation while incurring minimal collateral thermal damage. Surgeons are currently using the laser for surgery on certain brain tumors, certain vascular malformations, delicate inner ear and hearing restoration procedures, and some trachea, larynx and vocal cord procedures.

BRAIN TUMORS: According to the American Brain Tumor Association, an estimated 52,236 new cases of primary brain tumors were diagnosed last year. Brain tumors are the second leading cause of cancer-related deaths in children under age 20. They are also the second leading cause of cancer-related deaths in men up to age 39. In 2008, the American Cancer Society reported a significant decrease in the number of brain and central nervous system cancer deaths over the past 13 years. Deaths due to malignant brain tumors decreased more than 14 percent between 1991 and 2004.

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