New procedure allows surgeons to remove brain tumor without cutting brain

One wrong move during brain surgery can change a patient's personality forever.

Now, doctors have developed a new technique that allows them to remove a brain tumor without actually cutting through the brain.

The procedure helped a busy mother recover -- with her memory intact.

Irene Henein's crippling headaches made it impossible to keep up with her son.

"Everything would go black on me,” says Irene.

Scans revealed a tumor buried deep in her brain. Surgeons cut open her skull, but they could not reach the mass without jeopardizing her memory.

She lived with the tumor until she got pregnant again. Doctors said this time the mass had to go.

"Am I going to wake up the same person? Am I still going to remember everyone that is around me?" questioned Irene.

Doctors Amin Kassam and Daniel Kelly created the brain port procedure. Instead of cutting the tissue, they work through a small tube. It forms a path leading to the buried tumor.

Surgeons pull the tumor out through the tube. The brain then acts like a sponge.

"When the tube is removed, the surrounding brain is protected and has an opportunity then to come back to its natural position,” says Dr. Kassam, a neurosurgeon at St. John’s Health Center in Santa Monica.

Compared to a craniotomy, the brain port procedure cuts recovery from a month and a half to two weeks, it lowers the risk of disrupting vital brain structures, and it allows surgeons to reach deeper into the brain.

"I'm just very blessed and lucky that they were able to do this, and I'm still who I am,” says Irene.

Her tumor is gone, her memory in tact, and now Irene is getting ready for the new addition: a baby girl.

"She's our fighter,” says Irene. She's our blessing.”

Dr. Kassam has performed more than 100 brain port procedures. The surgery is done at two medical centers -- one in Santa Monica, and one in Pittsburgh.


BACKGROUND: A colloid cyst is a slow-growing tumor typically found near the center of the brain. If large enough, it obstructs cerebrospinal fluid movement, resulting in a build-up of fluid in the ventricles of the brain and elevated brain pressure. Most patients suffer from headaches and sometimes blurry vision. In the most serious cases, prompt surgical treatment is required to reduce the chance of sudden death.

BRAIN PORT: The brain port was designed to work within the brain substance itself or within the fluid system in the brain. The procedure uses a small needle and a dilator to part the fibers within the brain, creating access to the structures located below the surface. Using the dilator, a small, clear plastic tube is placed within the substance of the brain, and an endoscope is placed inside this tube. This creates an up-close and magnified view that is projected on a plasma screen.

This precise surgical pathway is used to remove the tumor. Surgeons use specialized instruments and work completely inside this small tube. Once surgeons remove the tumor, they rely on the concept that the brain behaves like a sponge. The brain port gives surgeons the ability to reduce brain tissue damage by working through delicate brain fibers using the protective port. Once the port is removed, the fibers have the potential of returning to their natural state with less disruption than with traditional surgery.

"The concept behind the brain port was to find a way of essentially parting the brain and separating the fibers, working along them rather than through them," Amin Kassam, M.D., Director of the Neuroscience Institute at St. John's Health Center in Santa Monica, California told Ivanhoe.

The port allows doctors to access cysts or tumors below the surface of the brain with less tissue disruption, preserves critical fibers of the brain and allows surgeons to operate closely to critical brain structures including the sections responsible for judgment and memory.

Dr. Kassam pioneered the brain port procedure and was the first in the world to perform it. He has done more than 100 cases using the brain port. St. John's Health Center and the University of Pittsburgh
Medical Center are the only two centers in the country performing the surgery.

Maribel Leyva
St. John's Health Center Neuroscience Institute
Santa Monica, CA
(310) 582-7450

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