Wednesday, August 11, 2010

VA Surgeon Uses 3D Imaging to Tailor Brain Tumor Surgery

By Hans Petersen, VA Staff Writer

The three-dimensional imaging system allowed the surgeon to precisely locate and remove the very large tumor.

Gulf War Army Veteran and former legal secretary Sandy Kemp had severe headaches for years. She also had blurry vision. Yet she put off going to the doctor — until one day she found she could no longer read.

The doctors diagnosed Kemp with a brain tumor. The partly calcified mass was enormous — the size of a grapefruit. It filled the right frontal corner of Kemp’s skull and crossed over to the left side.

Neurosurgeon Uzma Samadani, a veteran surgeon of more than 1,000 brain tumor operations, said Kemp’s tumor was not the largest she had ever seen, “but it was certainly up there in the top 10.”

Dr. Samadani decided that surgery, while risky, needed to be done as soon as possible. “The tumor was pushing her brain down and trapping the fluid-filled spaces in the brain.”

Kemp named her tumor “Harvey,” and knew he had to go.

Dr. Samadani operated two days later at VA’s Manhattan campus of the VA New York Harbor Healthcare System. Dr. Samadani’s six-person surgical team removed “Harvey” in a 5 ½ hour operation with serious risks, including a stroke in areas of the brain important for movement, personality, memory and awareness.

Now that her brain tumor has been removed, Veteran Sandy Kemp can read again.

Fortunately, a newly acquired three-dimensional imaging system enabled a VA surgical team to pinpoint as well as remove the tumor.

The procedure was a great success thanks to meticulous planning and Dr. Samadani’s neurosurgical expertise aided by three-dimensional imaging available with the new imaging system — called the “StealthStation S7” navigational.

“The S7 was extremely helpful in helping us determine where the margins of the tumor were, relative to a normal brain,” Dr. Samadani explained. “We are very excited and happy to have this technology here at the VA because it enables us to tailor our approaches and surgery to the anatomy of the patient’s brain and tumor. It enables faster surgery with less risk to surrounding anatomy. It allows us to provide the highest standard of care to our patients.”

Kemp awoke following surgery with no memory loss, and no problems with her speech or movement.

“We knew her personality would be different. She is now less talkative and less tolerant of anything irritating her. But just having her wake up okay — and already joking around — following removal of such a big tumor was fantastic. She was smiling an hour after emerging from general anesthesia,” Dr. Samadani remembers.

She had given Kemp only a “60 to 70 percent” chance of having such a positive outcome.

Kemp returned home to Pennsylvania six days after the surgery. Understandably, she was more than pleased. “It was really time for Harvey to go,” she said.

Following her surgery, Kemp received physical and speech therapy rehabilitation for three months, first at the Lebanon VA Medical Center, and then at the Defense and Veterans Brain Injury Center (DVBIC) in Johnstown, Pennsylvania.

Kemp says the only difference she detects since the surgery is that now she can’t smell well. Joking that today she feels “finer than frog’s fur,” Kemp is looking forward to heading to Colorado where she plans to train to be a veterinarian’s assistant.

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