On Topic Video Transcript
Jonathan Engh, MD
Director, Neuroendoport® Surgery Program
The neuroendoport is a device that we use at UPMC for the minimally invasive removal of selected brain tumors. It allows us to remove these tumors with less manipulation of the surrounding brain that is functional, active brain. And as a result it allows us to minimize any negative effects on the patient as a result of removal of this tumor.
Both benign and malignant tumors have been successfully removed using the Neuroendoport
. The key predicting factors are the anatomy of the brain around it, how deep the tumor is and how well we think we can visualize it. In general, deeper tumors tend to be the best candidates. So oftentimes, if people have tumors that are within the fluid system of the brain, the ventricular system, those are great candidates. Tumors that have a significant cuff of surrounding tissue tend to be great candidates. Tumors that are very superficial that are almost directly underneath the skull tend to be poor candidates. Those can be done conventionally very effectively.
The neuroendoport approach allows us to make smaller incisions, smaller bone openings and less manipulation of the brain in order to remove a tumor especially if its deeper in the brain. It also allows us to have a equivalent if not increased effectiveness to conventional approaches for selected tumors in terms of the amount of tumor that we can successfully remove. We have seen as a result of this that for selected tumors patients can have shorter hospital stays with this approach and quicker recoveries than they would have with a conventional operation.
The follow-up ends up being very similar to what it is for conventional brain operations. Obviously, these people tend to have smaller incisions and less postoperative pain but if you have a malignant tumor the neuroendoport does not make it curative by surgery. You still have to have adjutant therapies which are added on to the surgery that you had such as chemotherapy, radiation, sometimes clinical protocols.
Expertise and Experience
The reason to come to UPMC to have brain tumors treated is that we can take a multidisciplinary approach in which we apply breakthrough technologies such as neuroendoport in consideration of what would be best in order to remove a tumor. Neuroendoport is one great option for certain tumors, sometimes conventional craniotomy, sometimes awake craniotomy
, sometimes brain biopsy, sometimes no surgery at all. We’re experts in all of these. The neuroendoport in particular has a very steep learning curve and while there are some variations of it in other institutions we have a rather special perspective and experience here with a very high volume and very good patient outcomes. So the advantages are really the effectiveness of the approach here, the experience here but also that we are top notch in every other technology for brain tumor removal and subsequent treatment