Navigating the Brain

By Sylvia Perez, WLS, ABC7 Chicago

April 12, 2007 - Minimally invasive brain surgery has been available for awhile. But new technology allows doctors to see the brain like never before. For stroke and aneurysm patients, it may mean not only less invasive procedures, but more effective surgery.

The images are more like something from a science-fiction movie. But the future is now. A 3-D picture is actually helping surgeons make crucial decisions while operating inside a woman's head.

"You really have to forget everything you know about surgery, everything you know about medicine in general," said Dr. Demetrius Lopes, neurosurgeon, Rush University Medical Center.

At Rush University Medical Center in Chicago, Dr. Demetrius Lopes works in a small but growing area of medicine known as neuroendovascular surgery. Just as other physicians are able to fix the heart with out a major operation, minimally invasive surgery is now possible in the brain. Some call it drill-free brain surgery. Twenty-nine-year-old Anuja Mehta calls it an amazing option.

"It is a very cool thing," said Mehta.

Mehta is nearly up to full speed just nine days after this surgery for a brain aneurysm. A more traditional approach would have required weeks of recovery.

"I thought if I could get just as good results, without doing open surgery, that would be a better option for me," said Mehta. "With this type of technology we are finding that we can offer some treatments to patients that before we could not treat," said Dr. Lopes.

Repairs in the brain can be made with tiny devices delivered through a catheter inserted near the groin and fed up through a blood vessel to the brain.

Getting to the problem is one challenge; being able to fix it is another. That's where this advanced imaging comes in. As the surgeon negotiates the twists and turns of the blood vessel, a computerized 3-D image can be rotated to view from any angle.

For example, Dr. Lopes knew one patient had an brain aneurysm, but he wasn't sure how big the problem was. Highly specialized x-rays and some amazing software helped him to see the aneurysm was bigger than they thought and helped his team determine what to do next. They filled in the weakened area and placed a stent to secure the blood vessel.

"As you are doing surgery you can check and make sure your repairs are looking good," Dr. Lopes said.

The hope is this will not only make the surgery safer but also more precise. Whether this type of surgery is more accurate is still debatable. The technology is so new there isn't enough science to prove patients outcomes are better. Still, doctors want patients to know this option exists.

"If I can offer for the patient to have the same surgery done without having open surgery that makes a huge difference," said Dr. Lopes.

Rush claims to have one of the most cutting edge endovascular suites. But many other hospitals also offer minimally invasive brain surgery. Just because it is high-tech or less invasive doesn't always mean it is the best choice. Each case is different and there are doctors who say traditional open brain surgery is still a good option.