Friday, September 5, 2008

Carondelet Institute moves neurosurgery to new heights here

[Source: Ed Egger, Inside Tucson Business] - Several hundred patients who have needed to leave Tucson for complex neurological care should not have to do that starting early next year when Carondelet Health Network’s Neurological Institute is completed on the campus of St. Joseph’s Hospital.

Being touted as the area’s largest and most technologically sophisticated neurological center, the $35 million facility will be the first in North America — and second in the world, after one in Singapore — to offer the BrainSuite iCT.

In a nutshell, the BrainSuite iCT is a German-developed technology that makes it possible to perform nurosurgeries while simultaneously monitoring what’s happening in real time while the surgery takes place.

The drive to bring the iCT to Tucson was spearheaded by neurosurgeons Eric Sipos and Robert Goldfarb.

"Let’s say a surgeon implanted an electrode in the brain for different purposes to affect brain functions," Dr. Sipos said. "There are a lot of the things we do to modify how the brain functions. Our standard way of doing it today would be to get an MRI before surgery, bring the patient to the operating room, and place any information we need on cart.

"None of the equipment talked to each other. So we’d be using yesterday’s data to guide our decision making. Once we’ve finished the job and implanted whatever we want to implant, we’d send the patient to recovery. The next day we’d get a CT scan and check our work. If there is something we’re not happy with, we’d have to send the patient on another trip to the operating room, administer another anesthetic, and do the surgery all over again."

With the iCT, Sipos said, all monitoring devices are built in, providing immediate and real-time and interactive feedback on how the patient is doing. So neurosurgeons don’t have to count on results from yesterday’s MRI and they can see the immediate results of whatever they do.

"Every intervention carries with it a risk," Sipos said, "and the iCT will greatly enhance safety because neurosurgeons will know the effect — in real time — of what they’ve done."

Sipos said he spent months with architects, working out miniscule details and very fine measurements in designing the three dedicated suites at the new institute that will accommodate the iCT and represent $12 million of the institute’s $35 million pricetag. He even flew to Munich, where Siemens, the company that makes the iCT, is headquartered.

"As unique as it is, however, the iCT isn’t the only impressive medical technology that will be part of the new institute. Another is stereotactic radiosurgery, a highly precise form of radiation therapy used to treat benign and malignant tumors of the brain and spine and some functional brain disorders. This is the technology that will be featured in the new institute’s Brain and Spine Tumor Center.

While part of this technology’s name is "surgery", it is actually a non-invasive, non-surgical treatment option. Compared with conventional radiation therapy, this method uses high-dose radiation delivered by stereotactic techniques with sub-millimeter accuracy. This precisely shaped beam of radiation allows normal tissues to be spared the effect of the radiation.

This technology doesn’t actually remove tumors, but damages the genetic material of tumor cells, causing them to lose their ability to reproduce. After this treatment, benign tumors usually shrink over a period of 18-24 months and malignant and metastatic tumors may shrink in just a couple of months.

The institute features 42 inpatient beds dedicated to neurology, according to Jean Glattke, director of rehabilitation and the neurosciences service line. She said 24 of the beds are for medical-surgical use, 12 are for critical care and six are "step down" beds for patients in rehabilitation. Glattke said the institute’s dedicated staff includes 106 nurses, technicians and therapists.

The institute also will have a spine center, which focuses on a team approach in diagnosing, treating and correcting spine injuries and disorders using advanced technique and therapies.

In September, Western Neurosurgery Ltd., the neurosurgeon group that will be the primary user of the new facility, will move into a new, four-story 90,000-square-foot physicians office building adjacent on the hospital’s campus, 350 N. Wilmot road. This will allow for 24/7 physician coverage. About 40,000 square feet of the space will be dedicated to the Neurological Institute, including a wide range of neurological diagnostic and treatment outpatient services — radiation oncology and therapies and advanced imaging.

Glattke said Carondelet Network’s decision to launch the institute was "a very courageous decision because of the investment. But it was the right thing to do. People should never have to travel to get the care they need."

Sipos said selling the project to the Carondelet’s board was "easier than you might think."

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