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Innovative Neurosurgery & NorthShore’s Surgical Theater

Monday, May 01, 2017 10:38 AM

Current technology has already opened the door for more personalized and timely treatment. How has NorthShore kept in the forefront? Dr. Shakeel Chowdhry, NorthShore Neurosurgeon, shares how our surgical teams have adapted to the changing environment, and how new 3D technology has impacted patient care.

How has new technology helped to advance neurosurgery?
Neurosurgical outcomes have improved in recent years due to advances in diagnosis and surgery. More advanced imaging modalities coupled with improvements in both surgical implantable devices and surgical instruments have allowed us to perform more surgery with better outcomes and faster recoveries.

What has the NorthShore Neurological Institute done to stay in the forefront of the field?
NorthShore is committed to providing the best care for its patients. Part of this commitment requires attention and incorporation of cutting edge advances around the country and world that have shown benefit as well as serving to define and create some of these advances ourselves. This requires a top level group of physicians committed to excellence. Our physicians have trained in top centers in Chicago and around the country and are committed to further advancing the field of neurosurgery. They further this knowledge throughout training of residents and fellows. In addition, our physicians participate in multicenter national and international trials to further advance neurosurgery.

Specifically, these recent years has seen the incorporation of new minimally invasive cranial surgical techniques, advanced subcortical white matter tract imaging, and surgical simulation / virtual reality planning.

What are some of the latest technological advancements that have been adopted by the team/what are they being utilized for?
We are continually adopting and adapting technology to provide the best care for our patients. Recently, we have incorporated the 6 pillars approach for preservation of important tracts deep within the brain. We utilize new imaging modalities from Synaptive to visualize these tracts and a minimally invasive tubular retractor (NICO) to more safely access deep regions within the brain.

We have adapted this technology to provide safe removal of hemorrhagic stroke blood clots in the early period and are part of a multicenter national trial evaluating outcome from these procedures. We are the only center in the state of Illinois providing this surgical option.

We have incorporated advances in endovascular therapy and treatment such as flow diversion to allow for minimally invasive treatment of aneurysms and vascular malformations with patients routinely going home less than 24 hours after surgery. Similarly, we continue to advance ischemic stroke treatment utilizing a clinical perfusion mismatch evaluation (also unique to our hospital system in the state of Illinois) and advanced intervention techniques including stent retrievers to provide patients with ischemic stroke outside of the traditional window for intervention to have the opportunity to improve and recover.

Can you tell us about the Surgical Theater?

Surgical theater is a surgical rehearsal platform that allows a surgeon to a create a virtual three dimensional rendering of a patient’s unique anatomy using CT, MRI, and angiography imaging to allow improved understanding of surgical anatomical considerations, allow for virtual surgery ahead of time, and help improve patient understanding of their disease.

You have been able to perform advanced procedures to treat time-sensitive conditions like aneurysms using the Surgical Theater– how has it changed the treatment process?
Surgical theater allows the surgeon to fully evaluate the anatomical considerations relevant to a patient’s surgery and anticipate potential problems ahead of time. It can also allow for planning such as a clip selection and placement reducing the time needed for surgery and potentially the complication rate of surgery as well. In one recent case, it allowed for preoperative planning of approach angles and device selection meaning less time in surgery. The recent aneurysm patient was treated with a surgery that lasted less than 30 minutes and she was under anesthesia for only one hour.

Are other departments at NorthShore planning to use Surgical Theater?
It has not yet been incorporated for the neurologists. We are beginning to develop paradigms for spinal disease and anticipate extending its use to the fields of ENT and possibly general surgery.