Thursday, April 23, 2015

A remarkable surgical technique

“The chief function of the body is to carry the brain around.” — Thomas A. Edison

I'M SHARING this story from NBC Southern California Channel 4 not because of its sensational, tabloid nature: a woman is diagnosed with a brain tumor, but it turns out to be an embryonic twin in her brain. A) I'm not making this up and B) Ewwwww!

I'm offering it to you so that you'll know about this particular clinic and doctor who performed the surgery, and most especially the revolutionary surgical technology he and this clinic pioneered. You never know if or when you or someone you love might need this specialized surgical procedure.

Yamini Karanam

Here's a link to Dr. Hrayr Shahinian and the Skullbase Institute in Los Angeles and a description of his specialty from his website. The story runs last.

Minimally Invasive Endoscopic Skull Base and Brain Surgery

The Skull Base Institute (SBI), is the first and only center devoted entirely to the art of skull base surgery. It is the first institute to perform every procedure using minimally invasive endoscopic techniques and after pioneering endoscopic pituitary surgery, the only institute doing fully endoscopic surgery to treat acoustic neuromas, meningiomas, craniopharyngiomas, pineal tumors, arachnoid cysts, trigeminal neuralgia and hemifacial spasm. 

These techniques result in fewer complications, less pain and faster recovery than "open brain" craniotomies. SBI's director, Dr. Hrayr Shahinian, is not a Neurosurgeon. He is exclusively a Skull Base Surgeon who has done a lengthier and more specialized training to include skull base, craniofacial and microvascular fellowships. These skills make SBI's team uniquely qualified to operate on the most complex area of the human anatomy and contributes to the success in treating over 5,000 skull base patients.

Embryonic Twin Discovered in Woman's Brain During Surgery in LA
By John Cádiz Klemack
April 21, 2015

An Indiana woman undergoing surgery in Los Angeles to remove a tumor experienced a twist worthy of a sci-fi plot when doctors discovered an embryonic twin in her brain.

Yamini Karanam, 26, was unaware of what was happening in her head until she underwent a procedure designed to reach deep into the brain to extract the tumor. After waking up from the surgery, Karanam was surprised to learn of the "teratoma" -- her embryonic twin, a rarity in modern medicine, complete with bone, hair and teeth.

Karanam realized last September that something wasn't registering in her mind. The Indiana University Ph.D. student was experiencing trouble comprehending things she read.

"Problems with reading comprehension, listening comprehension. If a couple people were talking in a room, I wouldn't understand what was happening," Karanam said.

What became more frustrating for Karanam was that her doctors would contradict each other regarding the source of the problem.

"The neurologist would say the neurosurgeon is not being practical in your case," Karanam said. "And the neurosurgeon would say the neurologist is not being optimistic in your case. And I'm like, could someone be educated about this?"

That's when her own research led her to Dr. Hrayr Shahinian at the Skull Base Institute in Los Angeles. Shahinian developed a minimally-invasive way of reaching deep into the brain to extract tumors.

"Unlike traditional brain surgery where you open the skull and use metal retractors and you bring a microscope to see in the depths of the brain, what we're doing is keyhole surgery," he said.

The method uses fiber-optic technology with digital imagery. A half-inch incision into the brain allows for an endoscope to reach in and slowly and very delicately chisel away at the tumor.

Karanam awoke to learn what was causing her all that trouble in Indiana. She lightheartedly called the tumor her "evil twin sister who's been torturing me for the past 26 years."

"This is my second one, and I've probably taken out 7,000 or 8,000 brain tumors,” Shahinian said.

Shahinian said his fear was that tumor may be cancerous. Pathologists, though, determined that not to be the case and Karanam is expected to make a full recovery in only three weeks.

Karanam said her biggest frustration was that so many other brain surgeons had no idea Shahinian's technique was available.

"It's really unfair that people don't know about it," she said. "This has to be mainstream. This is the first thing that they should get you. When they know you have a pineal tumor, they should tell you, ‘You know what? There's a minimally invasive approach in which they won't kill you, they won't leave you with a disability. There's a way in which you can live your life just the way you want to.’”

Shahinian said before he invented his technique, the only option to remove this type of tumor would have been surgery that included removing half of the skull. He says because the brain is such a sensitive organ, the less it's disturbed, the better.

"We want to be in and out without the brain knowing we were there, and I think that's the beauty of this technique," Shahinian said. The method uses fiber-optic technology with digital imagery. A half-inch incision into the brain allows for an endoscope to reach in and slowly and very delicately chisel away at the tumor.

Karanam awoke to learn what was causing her all that trouble in Indiana. She lightheartedly called the tumor her "evil twin sister who's been torturing me for the past 26 years."

1 comment:

  1. Minimally invasive surgery is one of the best things to happen in medicine, within our lifetimes! To apply it to the brain is brilliant! And right here in So Cal. Way cool. I will remember this if we are faced with such a need. Thank you.

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