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City of Hope’s top-ranked neurosurgeons utilize the most advanced tools available to remove brain, pituitary, and spine tumors. These tools, some of which are not generally available elsewhere, allow for neurosurgery with greater precision and fewer adverse events, resulting in significantly improved patient outcomes.
Minimally Invasive Surgery
 City of Hope not only has the most sophisticated surgical robots and other equipment for performing minimally invasive cancer surgeries. We also have highly experienced surgeons, who have performed more robotic procedures than many other hospitals in the nation, reinforcing our commitment to pioneering cancer treatments. These minimally-invasive surgeries offer benefits to patients and doctors - such as smaller incisions, less blood loss and pain, and shorter hospital stays - that traditional surgery and regular laparoscopic surgery cannot. The Brain Tumor Program makes extensive use of these techniques, and is achieving notable success.
One example of how minimally invasive techniques are being used in neurosurgery at City of Hope is the endonasal transsphenoidal procedure, in which surgeons operate on the brain through the nose to remove pituitary tumors as gently as possible. This endonasal approach unites the visual precision of a tiny camera, called an endoscope, with the power of a navigation system, magnetic resonance imaging and highly specialized microscopes. The equipment in City of Hope’s operating room magnifies the small surgical field while the StealthStation AXIEM electromagnetic navigation system guides surgeons to their targets.
Ultrasound
Precise ultrasound allows City of Hope surgeons real-time imaging of the surgical site so they can better assess the tumor tissue to be removed.
Sonopet Ultrasonic Surgical Aspirator
The Sonopet Omni is an outstanding innovation in neurosurgery technology allowing surgeons better access to difficult-to-remove tumors. It permits the surgeon to ultrasonically remove the tumor and bone while helping to prevent soft tissue damage, infection, inflammation and vision loss.
OPMI Pentero Surgical Microscope with Stealth MRI
 The Zeiss Pentero microscope with tumor luminescence helps differentiate tumors from healthy brain tissue, which enables surgeons to remove tissue more completely and selectively. That means fewer problems after surgery and improved patient outcomes.
Fluoroscopy
City of Hope physicians use standard fluoroscopy to better see and monitor tumors during surgery. Fluoroscopy is like an x-ray, but the image is viewed on a screen rather than on film. The radiologist can then watch the images "live" on a TV monitor. Health-care professionals often use fluoroscopy during many radiologic procedures to observe the action of instruments physicians are using to diagnose or treat the patient.
Additionally, City of Hope will soon offer some of the leading-edge tools of tomorrow including:
da Vinci Surgical System
The da Vinci Surgical System is a futuristic surgeon controlled "robot." It provides surgeons with an alternative to both traditional open surgery and conventional laparoscopy, also called keyhole surgery. The da Vinci System enables surgeons to perform even the most complex and delicate procedures through very small incisions with unmatched precision. While the FDA has not yet approved the da Vinci Surgical System for brain surgery, City of Hope physicians are working closely with Intuitive Surgical to develop this application. FDA approval could come as early as fall 2008.
3-tesla magnetic resonance imaging (3T MRI) machine
The 3T MRI machine provides physicians enhanced imaging capabilities, improving the accuracy of diagnoses and treatments. 3T MRI has twice the power of most MRIs in clinical use today. The machine’s added magnetic intensity allows for finer resolution of images or faster scanning, which increases diagnostic precision and helps target solid tumors for treatment.
The new machine lets physicians perform scans, such as a functional MRI, that are useful before brain surgery to determine areas of the brain that need protection. Such scans can determine the exact brain areas used for speech, movement and cognition. The 3T MRI can assist in fine-tuning radiation treatment to tumor sites and limiting exposure to healthy tissues. Reducing scan time is also helpful in pediatric patients and other ill patients who have difficulty remaining still for prolonged periods of time.
Convection-enhanced delivery
 Convection-enhanced delivery is a recently-developed, minimally invasive method that can be used to perform molecular neurosurgery on brain tumors. The technique, also referred to as “high flow microinfusion,” was pioneered at the National Institutes of Health by Dr. Edward Oldfield. Convection is a central nervous system drug-delivery technique that bypasses the blood-brain barrier — the natural barrier that keeps many drugs from moving from the bloodstream into the brain, where they are needed. The technique also allows drugs to be targeted directly to cancerous tissue (see image below). This method allows highly concentrated cancer-fighting drugs to go to the tumor while minimizing the amount of the drugs that go to normal brain tissue and throughout the body.
OPMI Pentero Surgical Microscope with fluoroscopy
The OPMI Pentero (see description above) gives surgeons another tool to help them remove tumors: fluorescence. The system uses different wavelengths of light, such as infrared, to give surgeons a whole new look at vital structures in the brain. While not yet available for use in the United States, these and other new tools represent significant evolutionary advances in surgical microscopes.
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 With your help, City of Hope researchers pursue new clinical and laboratory findings, support promising young scientists, and acquire new laboratory technology.
Contact Donor Relations at 800-720-6824 for more information. |
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