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Brain surgery of a different sort

Patient is awake for minimally-invasive procedure at MGH

May 7, 2013
By ABBEY HAUSWIRTH - Journal Staff Writer (ahauswirth@miningjournal.net) , The Mining Journal

MARQUETTE - When Robin Charlebois came home from dinner with her husband on Jan. 25, it seemed like a normal Friday night. She threw on her pajamas and sat down in her recliner chair. Little did she know that would be the last thing she would remember for four days.

Charlebois, 60, of Wells had suffered a seizure. She was rushed to OSF St. Francis Hospital in Escanaba and shortly after, she was transpoprted to Marquette General Hospital. There, she was seen by Dr. Richard Rovin, a neurosurgeon.

Rovin compared an MRI from January to a second MRI that was taken in February. What he discovered was a brain tumor on the back left side of Charlebois's brain that was growing substantially.

Article Photos

Cherie Radabaugh, left, and Heather Stupsky, right, both radiation therapists at Marquette General Hospital, prepare Robin Charlebois for her radiation treatment. A mold of Charlebois’s face was taken during a previous appointment. The mask is used for all six weeks of radiation. (Journal photo by Abbey Hauswirth)

Charlebois was approached about a new procedure that would be a minimally invasive way to reach the tumor without causing trauma to the brain. The catch: Charlebois would be awake during the procedure.

"It didn't scare me," Charlebois recalled. "Bottom line was, I knew that tumor needed to come out and Dr. Rovin made me feel much better about the procedure."

The NICO Myriad, which was used to remove the tumor, is the first automated and non-heat producing tumor removal device to operate in surgical and endoscopic surgical approaches in the central nervous system.

The device was designed by Amin Kassam, a leading neurosurgeon at Ottawa General Hospital in Ottawa, Canada. It has a slender design with a malleable tip that offers control and precision, delivered by the doctor through a foot pedal mechanism.

Physicians are better able to travel through fragile tissue, cutting near or on critical areas such as optic nerves without causing trauma to the brain.

MGH was the first center in the United States to use this technology and performed the first procedure in June of 2012.

"Since then, we've operated on 23 patients," Rovin said. "For some patients, this offers hope where there wasn't any before."

While not every patient is a good candidate to be awake during the procedure, Charlebois was the first of four to do so.

"We were laughing and telling jokes during it all," Charlebois chuckled. "I found out that Dr. Rovin loves Vango's Pizza and I told him about how I don't like Willie Nelson music."

The surgery took five and half hours. During that time, a speech pathologist did flash-cards with Charlebois to keep her mind active.

"It's best when we can keep them awake," Rovin noted. "We can examine them in real time... with one patient we were able to see that his speech was improving as we performed the procedure. When a patient is awake and interactive, it's the best way to judge whether we're having a negative impact or not."

Rovin stated that this is a new approach on brain legions, hemorrhages and blood vessel malformations. Without this technique, it was very difficult to safely reach deep-set tumors and often a surgical removal was not an option.

He added that there are a few reasons he believes MGH was chosen to be the first to carry this technique in the U.S. Those include having a strong team in the operating room who were eager to learn the new procedures; a supportive hospital willing to acquire the necessary equipment and strong community support. Rovin said there are currently more than 50 patients with brain tumors in the Upper Peninsula who are scheduled to be operated on.

"I think for many of our patients this is absolutely game changing."

For Charlebois, the only word she could use to describe the outcome was "phenomenal."

"It was so well orchestrated!" she exclaimed. "Every person had a spot (during the procedure) and they took such great care of me and my family."

Although a large portion of the tumor was removed, Charlebois does have to undergo two treatments to assist with the remainder. On April 24, she began both radiation and chemo therapy. She receives radiation five days a week for six weeks, as well as taking an oral dose of chemo for 42 treatments. Afterward, another MRI will be performed to monitor her progress.

In honor of May being Brain Tumor Awareness Month, MGH will hold it's 8th annual fundraiser "Hope Starts Here," on Saturday. The event will include a half marathon, a 5 and 10K run and a triathlon. To learn more, visit www.hopestartshere.org.

Abbey Hauswirth can be reached at 906-228-2500, ext. 240.

 
 

 

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