09/09/2013

Surgery and technology light years ahead of where it was 25 years ago

MORGANTOWN, W.Va. – Twenty-five years ago, it might have sounded like part of a science fiction plot – operating on a patient with remotely controlled, robotic arms or using a 20-ton medical instrument that emits more than 200 radiation beams at a precise location.Ruby-25-logo.jpg

Minimally invasive treatments, computerized robotic tools and advanced diagnostic capabilities have all revolutionized medical care at Ruby Memorial Hospital and positioned WVU Healthcare to remain a leader for the state of West Virginia.

Gamma Knife is one of the minimally invasive surgical tools that has transformed the treatment of benign and malignant tumors, facial pain and brain disorders. Ruby Memorial Hospital has the only Perfexion Gamma Knife radiosurgery unit in the state of West Virginia.  

Though the name may be deceiving, it’s not actually a knife, and it’s not surgery in the traditional sense. Without the risks of open surgery or an incision, this 20-ton medical instrument emits 201 finely focused beams of gamma radiation at the precise location of the brain disorder and treats it with minimal effect on surrounding normal tissue.

“This system is jointly operated by the departments of Neurosurgery and Radiation Oncology, and it’s designed to deliver precise single treatment high dose radiation to benign and malignant brain tumors,” Geraldine Jacobson, M.D., professor and chair, of the WVU Department of Radiation Oncology, said. “We are able to treat individual brain metastases without irradiating normal brain tissue and treat brain tumors that are difficult to treat with surgery alone.”

Also at Ruby Memorial Hospital, robotic-assisted surgery allows WVU surgeons to perform procedures with fewer risks for patients. The da Vinci robotic arms are guided remotely by a surgeon’s hands and allow for pinpoint accuracy on major surgeries through tiny incisions. With no large, open incision, there is minimal trauma to the patient. A miniature camera attached to one of the four robotic arms gives the surgeon a highly magnified, three-dimensional view. Reduced pain and blood loss, shorter recovery time, reduced scarring and risk of infection and a faster return to daily activities are all benefits of surgeries using da Vinci.

WVU Healthcare offers robotic-assisted options for a range of surgeries, including: prostate, bladder, kidney, and gynecologic cancer surgeries; hysterectomy; and uterine fibroid surgery.

WVU Department of Obstetrics and Gynecology’s Mahreen Hashmi, M.D., uses da Vinci to treat female patients for reproductive procedures.

“The greatest changes in the minimally invasive surgical realm have been in the advent of the hysterectomies,” Dr. Hashmi said. “With robotic techniques, women do not have to undergo an abdominal procedure resulting in days in the hospital and months of recovery, not to mention time away from work and their families. Now, it’s a less-than-24-hour hospital admission, very small incisions about 1 cm diameter, and a return to their daily activities within a few weeks. This has translated into a higher quality of life for women and their families.”  

Neuro-Angio-Suite-Photo.jpg“Everything surgery-related in general is headed toward smaller incisions and less invasive treatments,” Ansaar Rai, M.D., an interventional neuroradiologist for WVU Healthcare, said. Minimally invasive image-based technologies and procedures are used in interventional neuroradiology to diagnosis and treat diseases of the head, neck and spine.

Dr. Rai had a 38-year old female patient who anticipated having to lose her hair before brain surgery. “She didn’t want to have her hair shaved off, and she was very happy to learn about the new surgery technique, and that she would not have to lose her hair,” Rai said.

A young field, interventional neuroradiology has seen dramatic changes compared to others, Rai said. “To treat a brain aneurysm would require major brain surgery, but now, we can do brain surgeries through a small puncture in the groin. It cuts down on the recovery time and hospital stay, and psychologically, it’s less traumatic for the patient. Patients can go back to work faster.”

Ninety-two year old G. Robert Nugent, M.D., an adjunct professor in the WVU Department of Neurosurgery, is amazed at all of the surgical and technological advances he has lived to see today at Ruby Memorial Hospital and at the former University Hospital.

When Dr. Nugent first moved to Morgantown from New York in 1961, surgical techniques and diagnostic capabilities were limited, he said. His innovative neurosurgery training at Duke University made him an asset to the burgeoning facility.

Aneurysm surgery had a 15 percent mortality rate compared to a rate of 2 percent today. Tumors of the pituitary gland were treated by open surgery through the head instead of through the nose as they are today. The Department of Neurosurgery once did all of its own radiological diagnostic procedures in a suite in the radiology department. Some neurosurgeons also considered the idea of using a microscope to be somewhat intrusive to their procedures.

Nugent helped pioneer the use of the operating microscope in neurosurgery at WVU and became well-known nationally for his treatment of a nerve disorder called trigeminal neuralgia, which creates intense pain in the face. Nugent pioneered the use of minimally invasive radiofrequency current to interrupt the pain signals and treat the disorder with little damage to surrounding tissue.
 
“My 52 years at this institution have been a great adventure, primarily because of all of these remarkable changes,” Nugent said.

WVU Healthcare’s flagship hospital, Ruby Memorial, is celebrating its 25th anniversary. It opened on July 19, 1988, after a generous donation from Morgantown philanthropist Hazel Ruby McQuain. The anniversary celebration will continue through the fall, marking a quarter century of care for tens of thousands of patients.

Photo caption:
In the neuroangiography suites at Ruby Memorial Hospital, Dr. Ansaar Rai uses high-tech equipment to help diagnose and treat diseases of the head, neck and spine.

--WVU HEALTH--


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For more information:
Amy Johns, Director of Public Affairs, 304-293-7087
johnsa@wvuhealthcare.com
dc: 09-03-13

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