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eDocTalk article

Legacy adopts new approach for brain tumors, blood clots

June 2013

Lewis Low, M.D.

Jefferson Chen, M.D., is the first neurosurgeon on the West Coast to use a new approach that preserves brain function while treating deep-seated brain tumors and large blood clots caused by hemorrhagic strokes.

Using a tool called the NICO BrainPath, Dr. Chen can now reach and remove what was thought to be inoperable. He does this by integrating advanced technologies for imaging, mapping, optics, access and resection. Dr. Chen is one of fewer than a dozen physicians trained and credentialed to use BrainPath in the U.S.

"I’m pleased with the results from our first three patients," says Dr. Chen, medical director of trauma neurosurgery at Legacy Emanuel Medical Center. "Respecting the white matter with a more thoughtful approach leads to improved preservation of brain function." Legacy Emanuel is one of only 10 U.S. hospitals to offer the technology.

Less risk

BrainPath and minimally invasive techniques enable Dr. Chen to reach previously inoperable tumors with smaller incisions. This leads to a decrease in the risk of infection and bleeding, and a shorter hospital stay.

  • Imaging — MRI and/or CT scans serve as road maps for the surgery. The multi-colored images help Dr. Chen pre-plan a surgical pathway before the procedure begins. He seeks to create the best route to avoid areas such as white matter filled with thousands of nerve fibers that affect how the brain functions.
  • Mapping — The navigation system is like a GPS in the brain. It can pinpoint the precise location of the tumor and track in real time the exact location of each surgical instrument.
  • HD Optics — A high-powered telescope and camera above the skull opening improves intraoperative visualization, which helps to improve resection.
  • Access — One piece of the BrainPath is a narrow probe with a special tip that minimizes damage by displacing tissue as it advances through fiber tracts to the target site. Around the probe is a clear plastic tube that creates a safe surgical corridor to the tumor or blood clot in the farthest depths in the brain.
  • Resection — Dr. Chen then removes the tumor or blood clot with NICO Myriad, a pencil-thin tool designed not to generate heat, which minimizes damage to adjacent critical structures such as optic nerves and blood vessels.
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