Dr. Hrayr Shahinian New Less-lnvasive Procedures Reduce Pain, Recovery Time

Brain Surgery Made Simple Sending in the Tiny Robots by Peter Landers, Wall Street Journal October 31, 2002 End Quote

(1888PressRelease) December 15, 2010 - Looking at Doublas Baptist, you'd be hard-pressed to figure out he had brain surgery seven months ago.

Mr. Baptist's doctor opened up a hole in his eyebrow, plucked out a tumor bigger than a golf ball, then sewed him up again. Today, his eyebrow hairs cover the scar. "I'll say I had brain surgery and people say, 'Are you crazy?'" says Mr. Baptist, 49 years old, a bridge-painting supervisor for the city of New York.

This is the latest frontier in "minimally invasive" surgery. Over the past 15 years, doctors have tried to reduce the pain, scarring and long recovery periods traditionally associated with surgery in general. Instead of cutting a patient's abdomen wide open to remove a gall bladder or kidney, doctors do the surgery through small keyhole incisions. Now, thanks to better instruments, doctors can try similar operations on the most delicate organ of all: the brain.

"We used to have to shave off half the head," says Mr. Baptist's doctor, John Mangiardi of New York's Lenox Hill Hospital. "We don't do that anymore."

The term "minimally invasive" covers a wide variety of brain-surgery procedures. Some doctors insert an endoscope - a tiny camera and light - through the nose, or via an incision tucked behind the ears, to view the tumor area. In one particularly new and experimental Japanese technique, tiny tumor-excising tools like lasers and forceps are then inserted and guided with a joystick by a doctor watching on a TV monitor.

The decades-old approach to brain surgery is still widely used also because doctors need many years to master the new skills and then teach them to other doctors. "You can't just say, 'Give me an endoscope, I'm gonna do it,'" says Hrayr Shahinian MD, head of the Skull Base Institute . "It took me 10 years. I must have killed 200 pigs," he says. (Brain surgeons sometimes practice on pigs since their brains are roughly human-sized.)

The bad news is that many brain-tumor victims still won't benefit much from minimally invasive surgery - or, in fact any other kind of surgery. These patients have tumors that spread tentacles deep into the brain and multiply rapidly. "No one survives this disease. It's a death sentence," says Eric Holland of the Memorial Sloan-Kettering Cancer Center in New York.

Nowadays, MRI and CT scans give surgeons a good map of where a tumor is. During surgery, various computer techniques for creating three-dimensional live images can help surgeons avoid damaging the brain.

Advocates of minimally invasive surgery say they can cut costs by as much as half by reducing hospital stays. Dr. Shaninian of the Skull Base Institute says traditional brain surgery costs $50,000 to $150,000, but the newer techniques can bring that down to between $30,000 and $60,000.

Insurance generally covers minimally invasive procedures, unless the hospital attempts to bill more than it would for conventional tumor-removal surgery. It's best to check coverage ahead of time.

For more info:
http://www.hrayrshahinian.org

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