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Computer Assisted Neurosurgery Available in Butte

Patients in Southwest Montana requiring neurosurgery have new treatment options available to them, thanks to two state-of-the art computer systems purchased by St. James Healthcare in Butte. These sophisticated devices are designed to provide physicians performing neurosurgery and ear, nose, and throat procedures with access to detailed images of an individual patient’s anatomy both prior to and during surgery.

By Paula J. Peters for The Montana Standard

According to St James’ Community Relations Director, Karen Sullivan, the Vectorvision Compact and Vectorvision 2 frameless navigation systems were purchased from BrainLAB Inc. for the sum of $500,000 as a capital expense item for the hospital, earlier this year.

Sullivan said that the equipment was purchased by the hospital to assist Butte neurosurgeons Dr. Peter Sorini and Dr. Gus Varnavas in their quest to provide state-of-the-art treatment options for patients undergoing surgery at St. James Healthcare.

“ We needed to provide these two physicians with what they needed,” said Sullivan. “ They are building programs and we are trying to grow with them.”

BrainLAB Support Engineer Jim Davidson described the capabilities of this high-tech equipment, which vaguely resembles a portable X-ray machine.

“ It’s like a global positioning system for the body,” Davidson said, explaining that the systems have the capability to integrate patient scan results from diagnostics tests, such as MRI and CT scans. This information can be used alone or combined with photo views of patients undergoing surgery to formulate a detailed three-dimensional image of the patient on the instrument’s computer screen. This image serves as a map for surgeons, giving them an improved visual concept of the area being operated on.

Davidson said that the instruments are also able to track the precise position of the surgeon’s scalpel, in reference to the patient’s body, through the use of special markers placed on instruments prior to surgery. In the hands of a skilled surgeon, computer-guided surgery ultimately results in safer procedures, smaller incisions and shorter recovery periods for patients.

According to Dr. Varnavas, having this equipment available at St. James provides patients with surgical options that were once only available at major medical centers.

“ It takes you to another level as a center,” he said. “ What’s really neat is to have this kind of capability in a rural environment.”

Varnavas said the 3-D imaging provided by computer systems like the BrainLAB Vectorvision allows surgeons to better prepare for surgery.

“ It gives you extensive preoperative planning capabilities. You’re now able to custom tailor a surgical treatment for an individual. This is high end brain surgery,” he said.

Varnavas recently utilized the BrainLAB system in the case of patient Jena Nance, an oncology nurse at the hospital’s cancer center who came to his office earlier this fall to explore surgical possibilities involving the recurrence of a benign meningioma. He explained that tumors growing on the outer covering of Nance’s brain were exerting pressure on the optic nerve and distorting her vision.

“ The big problem was that she was going blind, and our primary goal was to save her vision,” Varnavas said. “ This piece of equipment was absolutely perfect for exactly what Jena had.”

PATIENT’S PERSPECTIVE

According to Nance, her ordeal began two years ago, when she began noticing changes in her vision.

“ I started going blind in my right eye,” said Nance, who went to see her ophthalmologist in order to determine the reason for her partial loss of vision. “ He sent me for an MRI.”

The test revealed that a tumor was pressing on Nance’s optic nerve. At that time, Nance went to Dr. Sorini to discuss her surgical options. She explored her possibilities and opted to have her brain surgery performed in Missoula. Nance’s tumor was removed during a complicated and lengthy surgical procedure. Biopsies showed that the tumor was a benign meningioma and Nance was given the prognosis that it would likely return within the next several years.

When Nance began to experience visual changes again, she returned to her ophthalmologist and once again found herself seeking advice in Sorini’s office. This time, Nance consulted with Sorini’s new partner.

Varnavas reviewed Nance’s case and presented her with the option of having her procedure performed in Butte. Nance explored the possibility, and made the decision to have her surgery performed locally. Nance underwent surgery at St. James Healthcare on Oct. 1 and currently is recovering at her home in Butte.

Six weeks later, Nance has nothing but positive comments about having her brain surgery performed in Butte. Nance admits that friends and family were skeptical about her decision to have the surgery performed locally.

“ My family and everybody around me were saying `are you sure?”’ she said. “ When you think of brain surgery, you don’t think of Butte, Montana ’85 but you should. I got phenomenal care.”

“ The care I got in Missoula was professional, but distant. They took very good care of me but I felt very much like I was a number” said Nance. “ You can’t pay people to care about you.”

Nance was impressed with the quality of care and the level of personal involvement she experienced with both her surgeon and the staff at St. James. “ You get the impression right away that this isn’t the meningioma at 10:15 — this is Jena Nance,” she said.

Varnavas explained that practicing in a smaller community such as Butte allows for a higher degree of personal involvement in each case. “ They’re not just your patients, they’re your neighbors,” he said.

Her recovery has gone well. Nance said she was up and awake the morning after the procedure, despite enduring nine hours of surgery the previous day. “ I was home in four days,” said Nance. “ That’s the way it goes when it goes well,” explained Varnavas.

Nance said having her surgery locally had many advantages. “ I had a hard time with follow-up care the last time,” she said. Nance said that the logistics of traveling to Missoula and having to handle much of her post-operative care by phone resulted in a frustrating recovery experience. “ Follow-up care here is very easy. I don’t have a problem getting what I need,” she said.

Varnavas said that although surgery such as Nance’s is made easier with devices such as the BrainLAB Vectorvision, the technology is only as good as the surgeon using it. “ It’s the combination of tools plus the training that allows us to put these technologies together and apply them to the next level,” he said.

http://www.mtstandard.com/health/health1.html

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