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    3-D Technology Takes Guess Work Out of Brain Surgery


    Kornel tells WebMD that he has done about 20 operations using the system. In addition to brain surgery he is using it for spine surgery such as herniated disc repair.

    In brain surgery, Kornel is concentrating on gliomas, brain tumors that start in the brain and have not spread from somewhere else. "Gliomas ... are difficult to see at the time of surgery." Using this system, he is able to more fully take out the tumor with more confidence, he says.

    Ratcheson says he thinks the MRI approach used for the past year at University Hospitals may be superior to the CAT system used by Kornel. "We take a different approach to this ... intraoperative CAT is somewhat limited as far as what it can tell you about the brain at the time of surgery." It is probably better for spine surgery because CAT scan is better for looking at bones, but for brain surgery MRI is better, says Ratcheson.

    Kornel agrees that MRI probably does give better images of the brain. He says, however, that he decided to proceed with CAT instead because "the [MRI] system is very cumbersome to work with and it?s very expensive. [CAT] is much more user friendly at the beginning," he says.

    Neither approach, however, is cheap. At Northern Westchester hospital, the Center for Minimally Invasive Neurosurgery spent $1 million to purchase the system and build a special operating room for its use. Ratcheson says University hospital "spent probably twice that much" for the MRI system.

    Both centers, however, say the benefits of the systems far outweigh the costs. For example, Kornel says, "there is less brain trauma, people feel better sooner and go home earlier." In the case of a brain biopsy, Kornel says that with the image-guided approach the "patient can go home the same day instead of 24-hour hospitalization that is the usual approach."

    Ratcheson agrees that the imaging systems are probably responsible for fewer complications after surgery and less brain trauma at time of surgery.

    Another advantage to this "miniaturization" is purely cosmetic, Roubeck explains. "I was so worried about my hair, that my head would be shaved. But they only took away a little hair just in front of my ear, it wasn?t even noticeable. Not even I noticed," she says.

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