Learn about 3-D Brain Surgery Software

Travis Stork: How do you remove that tumor using this technology? Dr. Neil Martin: Well, Travis, one of the key things now is localization. We have a GPS like system that targets the tumor precisely. I can see where the normal blood vessels are that I have to avoid, and I can see exactly where the tumor is. So whereas we used to make a big craniotomy, big opening in the skull so we wouldn't miss some critical part of the tumor, we can make the opening in the skull the size of the tumor or even smaller in some cases. Now how does that work? Well, her tumor was hard and firm almost like a super-ball; and you can't pull that out without deforming the brain tremendously, which we want to avoid. We want to remove the tumor with almost no contact, no touch technique. So if this represents a tumor what we do is we remove this center part. We core out the center part and we use this kind of an ultrasonic aspirator. The tip vibrates, it's a bit sharp and I can gradually bit-by-bit emulsify and suction out the center part of the tumor. Travis Stork: So piece-by-piece you have taken out the inner part of the tumor. Dr. Neil Martin: So the tumor is sitting there, we take the center part out until there is just a thin rind of the lemon left basically, and once that's done, then the outer capsule, the outer surface of the tumor becomes soft. We can compress it, so a tumor of this size shrinks down to a tiny shape, and you could see on the video that we could sneak that out through a real small little gap between the brain structures. Travis Stork: And walk us through this technology, which is so amazing, the interactive-ability, the images. Dr. Neil Martin: One of the key things for any major operation is to visualize it, just like Tiger Woods visualizes every shot on the golf course. I've got to visualize an operation from beginning to end. And if I can get an accurate view of what I am going to face during the surgery and plan out every step then most of the time the procedure goes exactly according to plan and the outcome is almost great, always great. So what we do now, historically we had two-dimensional images that we could scroll through like this. And this interface now allows us to view all the different angles and views simultaneously. This is actually the software we developed right at UCLA and is commercially available now. But one of the key things that a company called Vital Images does for us is take these two-dimensional images like coins and stack them and turn it into a three-dimensional image, that is life-like, that is more virtually real. And I use an image like this and scroll through this, and it's almost like putting my hands on the tumor. I can get a three-dimensional sense of what I am going to face during the operation. It's almost like a rehearsal of the surgery in a virtual-visual sense. We can maximize the whole thing. So I can turn and view the image from multiple different angles. Travis Stork: And point out everyone the tumor there so they can see it. Dr. Neil Martin: So the gold are the normal blood vessels, the normal venous channels, and the red portion is the tumor, tucked under the transverse and sigmoid sinuses, two critical venous channels right on the surface of the brain. Travis Stork: And what's amazing, you can avoid the blood vessels that are absolutely essential to avoid, but you also have this on your cell phone. Dr. Neil Martin: So if I am stopping off at a coffee shop on the way to work in the morning, I want to refresh my memory about what I am going to be facing in the operating room. I bring it right down to my phone. So on the phone I can look at exactly the same images that I've got available in the hospital. And again, go over it one last time, just to be sure, I know exactly what I am going to be dealing with. This also was very helpful in cases where I am called about trauma in the emergency room, and I've got to see what the scan looks like right-away to decide if the patient is going to be admitted to the ICU or rushed to the operating room. They don't want to have to wait while I am driving to the hospital to start the ball rolling. Travis Stork: So Su's tumor is gone, what's her prognosis now? Dr. Neil Martin: So I am pleased to tell you the pathology showed that it was a Grade 1 Meningioma, which is a benign tumor, has a very low risk of recurrence if you get all of it out and we did. So we will be doing surveillance scans in the future periodically, but I don't expect to see anything coming back. Travis Stork: Congratulations! Su: Thank you! Thank you so much! Travis Stork: Thank you, Dr. Martin.