Minimally Invasive Brain Tumor Removal, High-Tech Equipment, and Special Facility Benefit Patients

ATLANTA – Forty-seven-year-old Dale Hoggatt is no stranger to hospital operating rooms or surgical procedures. When Hoggatt was in his 30’s he was diagnosed with myxopapillary ependymoma, a condition in which slow-growing tumors form and grow on the spine. It has sent him to the operating room seven times for surgical removal, with long recoveries following each procedure. His condition has since left him wheelchair-bound.

When a brain tumor, which likely spread from his spine, was detected on a MRI scan and started to cause problems, Hoggatt mentally prepared himself for another grueling surgery – this time brain surgery – and another lengthy recuperation period. He soon discovered this surgical procedure would be different.

In July, Hoggatt and his wife drove from Vero Beach, Florida to Atlanta to be seen by Costas Hadjipanayis, MD, PhD, assistant professor of neurosurgery, Emory University School of Medicine, and chief of neurosurgery at Emory University Hospital Midtown. Hadjipanayis told Hoggatt about a minimally invasive procedure to remove his brain tumor through a small incision and 6.5 millimeter skull opening (about the size of a pea), rather than an open craniotomy (a surgical procedure to remove a section of the skull to gain access to the brain). The minimally invasive approach meant a shorter hospital stay and a faster recovery.

Hoggatt thought it was too good to be true. He returned to Atlanta the following week for brain surgery.

After making a small incision and skull opening on Hoggatt’s head, Hadjipanayis skillfully inserted a new neuro-endoscopic device called the NICO Myriad through a 2-millimeter channel in the endoscope to the tumor site. Hadjipanayis was able to remove the ependymoma tumor deep within Hoggatt’s brain in the third ventricle. The device’s superior control allows for extremely precise surgical work in removing both malignant and non-malignant tumors.

“This is one of our newest surgical tools for minimally invasive tumor removal located deep within the brain,” says Hadjipanayis. “We can now perform burr hole neurosurgery for deep midline tumors of the brain. Its small diameter at 1.9 millimeters is essential for insertion through a working channel on the neuro-endoscope to navigate around critical structures within the fluid-filled cavities in the brain. We can also use this device for removing skull base tumors after endoscopic access through the nose.”

Following his brain surgery, Hoggatt was discharged from the hospital four days later, spending only two of those nights in the intensive care unit.

“This was one of the most complicated surgeries I’ve ever had, but the easiest one I’ve ever had, too,” says Hoggatt. “The procedure was much less invasive than others and the recovery was so simple. I was truly amazed at the outcome.”

The Myriad system is one of several new high-tech systems installed in the recently opened neuro-endoscopic operating room suite at Emory University Hospital Midtown. Because the majority of the surgeries performed are endoscopic procedures, with small cameras projecting the surgical site in the brain onto monitors, clear and well-defined, high definition images are vital. The specialty operating room consists of four high-definition monitors, two overhead high-definition cameras and a state-of-the art control system that can conference out live procedures for teaching purposes.

“Patients with brain tumors are seeking less invasive means to remove those tumors and return to their lives without months and months of recuperation time,” says Hadjipanayis. “The neuro-endoscopic equipment we have today is really changing the way we remove brain tumors, meaning smaller incisions and skull openings, faster healing and better outcomes for certain patients with brain tumors.”