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St. Mary Neurosurgeons Perform Minimally Invasive Brain Biopsy
New technology helps advance Stereotactic Surgery Program.

LANGHORNE, Pa., May 28, 2008 – Neurosurgeons at St. Mary Medical Center now can perform minimally invasive stereotactic brain biopsies using a highly sophisticated stereotactic frame. This new technology advances the capabilities of an already well-established stereotactic surgery program at St. Mary.

In the minimally invasive technique, a light-weight frame is attached to the head while the patient is under local anesthesia. A computed tomography (CT) scan or MRI of the brain is obtained with the frame in place. A specific target in the brain can be precisely located with reference points in the frame and the target can then be accurately and safely reached by the neurosurgeon with a small needle to within one millimeter accuracy. This technique commonly is used for biopsy of deep-seated tumors or infectious or inflammatory lesions that may be difficult or dangerous to access through an open technique. “In using the most minimally invasive techniques available, we offer our patients the opportunity for the best outcome while reducing the risks of the procedure and reducing recovery time,” said Dr. Mark McLaughlin, a neurosurgeon on staff at St. Mary Medical Center and Princeton Brain and Spine Care.

The neurosurgeon's objective is to diagnose and treat the patient as soon as possible. A stereotactic biopsy reaches the lesion and extracts tissue for analysis in the pathology lab with the least amount of trauma to the brain. The tumor tissue and cells are then examined in the pathology lab to determine if cancer is present and if further intervention is required. It is important to have a correct diagnosis of a brain mass before initiating any treatment. The shortened recovery time of the minimally invasive procedure permits treatment, if needed, to begin almost immediately.

Stereotactic biopsy is a precise method of sampling a small region of brain tissue using computer- assisted image-guidance and minimally invasive techniques. Through only a skin puncture and tiny bony opening, an instrument is accurately passed into a brain lesion to obtain tissue for analysis. The spot to be biopsied is located three-dimensionally using CT imaging. The information is entered into a computer, and the computer calculates and precisely positions a needle to remove the biopsy sample. Stereotactic brain biopsy is a diagnostic tool for the evaluation of intracranial lesions.

Brain biopsies can be performed in two ways. A needle biopsy can be performed through a small hole drilled in the skill. Tumor specimens also can be obtained using an open surgical procedure. The procedure used to obtain the tumor specimen depends on many factors including the tumor location and the patient’s health.

The minimally invasive frame-based technique is superior in its accuracy in reaching the targeted area. This precision is especially important for small lesions close to eloquent areas of the brain that could suffer increased damage with a more invasive open surgical procedure. The technique usually is performed with the patient awake using local anesthesia and is painless. Typically, patients stay in the hospital overnight and tolerate the procedure very well.

If an open surgical technique is required, neurosurgeons at St. Mary use image-guided surgery known as the “Brain Lab” to target brain tumors with precision accuracy. This system uses an optical camera, a computer, and a laser to determine the precise location of a brain tumor. It is similar to having a Global Positioning System in the operating room. Yet instead of pinpointing a location someplace on the globe, the Brain Lab is able to zero in on diseased tissue without damaging the surrounding normal tissue.

The experienced neurosurgeons at St. Mary are highly skilled and perform hundreds of advanced procedures each year. Patients benefit from less invasive procedures as well as precision radiation therapy for cancerous tumors.

The diagnosis of brain metastases in cancer patients is based on patient history, neurological examination, and diagnostic procedures. Symptoms of a tumor may include headaches, weakness, seizures, sensory defects, or gait problems, as well as lethargy, emotional instability or personality changes.