Case Study: Neurosurgeon

Technological advancements contribute to the medical field more than storing information, however. Breakthroughs in technology allow surgeons improved methods in operations all over the world. Neurosurgeons at UC San Diego Health system found a way to revolutionize brain tumor operation. The team of scientists integrated 3D imagery, computer simulation and upgraded surgical tools to perform a very complex surgery through a miniscule incision (Carr). In comparison to making a large incision and removing an even larger section of the skull, the new procedure reduced the operation site, “[decreasing] the risk of the surgery and

“Patients can face modifications in their quality of life due to frequent headaches, nausea, seizures, neurological or cognitive deficits, and insomnia. Furthermore the treatment itself is often toxic and can result in considerable morbidity” (Gazzotti, Mariana, 2011). “Until recently, assessment of treatment response in brain tumor patients has been associated almost exclusively with radiological imaging response (characterized by tumor reduction in tumor dimensions), progression with symptoms and overall survival” (Gazzotti, Mariana, 2011). “In addition, quality of life may also reflect cognitive dysfunctional and functional limitations associated with the disease or as a treatment complication in these patients” (Gazzotti, Mariana, 2011). People suffering from brain cancer already go through an immense number of complications dealing with their disease alone, and the surgeon should really focus on the impact of treatment on the patient’s quality of life. Some common risks of Brain surgery are: bleeding of the brain, blood clots, brain swelling, coma, impaired speech, vision, coordination, or balance, and many more risks are

On December 23, 2014, neurosurgeon Jeffrey Leonard resected a brain tumor in a ten year old girl that was previously thought to be inoperable. Although it took two operations, due to modern technology and education Dr. Leonard was successful. The girl fully recovered from surgery and was awake and responsive the next morning. Modern surgeons’ knowledge of the human brain has evolved immensely through the ages. The first brain surgeons did not have anywhere near the knowledge that we possess today, but it is because of them that the current treatment of neurological problems is so advanced. Doctors can now perform advanced procedures such as the resection of tumors and clipping of aneurysms all while a patient is numbed and unconscious when previously treatment was a painful shot in the dark. Neurosurgery has evolved not only through extensive research of anatomy and a change in religious perspective, but came hand in hand with the development of anesthetics and the world’s major advancements in radiology and imaging.

Wrong kind of dye used to test the location in spinal cord caused the patient’s death in Tufts Medical Center. The neurosurgeon ask for a specific dye to provide it to the patient’s spine, however the pharmacy provided the different one due to the lack of the proper one. After checking the label, the neurosurgeon injected the dye to the patient’s spine. The patient woke up with a terrible pain and seizures and died the next day. The dye’s label warned against using it in a spine injection.

gradually stretch the tissue. Endoscopic foreign body removal also has the benefit of being able to visualize the damage or lack thereof

Possible symptoms of a herniated disc include pain that radiates through the back and possible down the arms or legs, depending on the location of the herniation. There can also be noted numbness and weakness of the arms and neck. Some people may not even know that they have a herniated disc because not all cases present with leg or back pain. Other signs and symptoms of a herniated disc may include muscle spasms or deep muscle pain. In extreme cases, a patient may present with weakness in both legs and/or the loss of bladder control and bowel control. This is a serious problem called cauda equine syndrome and requires immediate medical attention.

Endoscopic skull base surgery has very few incisions with the doctor using an endoscope to remove the tumor at the skulls base and/or brain by using the nasal cavity. This procedure provides a more effective removal of the tumor. Laser Interstitial Thermal therapy provides treatment for brain tumor and spine tumors. It is done by a probe being inserted into the tumor and then heating the tumor to extreme temperatures to kill it. Brain tumor such as gliomas and metastases can have this procedure used to treat them. Additionally, it helps reach hard to reach, deep set tumors, or irregularly shaped tumors and if the patient does not respond well to radiation. This procedure has also been used for spinal tumors. This is mostly used when the normal surgery techniques are not available. Furthermore, another type of procedure is the minimally invasive spinal stabilization which is a small (usually one or more half- inch) incision used for the surgery. It helps provide less blood loss as well as lowers infection rate with a shorter hospital stay and faster

Procedures: Nasogastric intubation, External beam radiotherapy, Percutaneous endoscopic gastrostomy, Lymphadenectomy, Therapeutic endoscopy, Gastrostomy, Radiation therapy, Digestive system surgery.

On 2/21/17 I went to the office of Neurosurgeon Dr. Schell. Ms. Ostrander had arrived and left before I arrived. Dr. Schell will not speak with case managers. I called Ms. Ostrander. She said Dr. Schell looked at the MRI disc and told her the compression fractures to her Thoracic spine had not healed and she needs a vertebral plasty done. This is going to be scheduled. He also told her that she has compression issues in her cervical spine but he would deal with this after the thoracic spine is taken care of. Dr. Schell’s office is supposed to schedule the surgery. The MRI done on 2/16/17 with and without contrast showed that the mild compression fractures at the anterior superior endplates of T5, T6, T7, and T9 are healed.

The first reason the endoscopic third ventriculostomy is the best choice in treatment is because, the chances of blockage is lower. “Shunting involves the implantation of two catheter and a flow control valve system to drain the excess cerebrospinal fluid form the brain’s ventricles to another

Introduction: During the resection of deep-seated brain lesions, there is an associated risk of significant retraction-induced brain injury due to the retractors used. The most common approach is the use of metal blade retractors to displace tissue, which has been shown to cause secondary life-threatening brain injuries such as brain swelling, hemorrhage, and infarction due to the excessive focal pressure on delicate tissue. This paper discusses the validation of a novel tubular retractor sheath which enables radial distribution of forces to minimize retraction-induced injury.

Most often, the tumor is removed through the nasal cavity. Rarely, if the tumor is large or has spread to nearby brain tissue, the surgeon will access the tumor through an opening in the skull.

Nasogastric tubes are placed after a surgical procedure, ie. whipples, puestows, and gastrectomies, to decompress the stomach or small bowel (Snaith & Flintham, 2014). These tubes are blindly inserted in the operating room normally by anesthesia once the surgery is complete. By definition, a blindly inserted nasogastric tube is one inserted without the use of imaging guidance, including fluoroscopy or ultrasound. The two most common complications of blindly guided tubes are insertion in the lungs and inaccurate placement in the esophagus. On rare occasions, nasogastric tubes have been lodged in the brain or spinal cord. As a result, x-ray verification has been considered to be the gold standard

This imaging system allows the surgeon to see an enhanced 3-dimensional view of the operative field and it provides direct eye-hand-instrument alignment and natural depth perception. This is possible through the use of a dual lens endoscope with two high-resolution cameras.

Technology is transforming the medical field with the design of robotic devices and multifaceted imaging. Even though these developments have made operations much less invasive, robotic systems have their own disadvantages that prevent them from replacing surgeons all together. Minimally Invasive Surgery (MIS) is a broad notion encompassing a lot of common procedures that existed prior to the introduction of robots. It refers to general procedures that keep away from long cuts by entering the body through small, usually about 1cm, entry incisions, through which surgeons use long-handled instruments to operate on tissue inside the body. Such operations are directed by viewing equipment and, therefore, do not automatically need the use of a robot. Yet, it is not incorrect to say that computer-assisted and robotic surgeries are categories that fall under minimally invasive surgery (Robotic Surgery, n.d.).