"This allows us to visualise human anatomy clearly during surgery and accurately navigate surgical instruments to the precise target destination. The technology tracks our instruments in relation to the patient's anatomy and even takes into account body movements that may occur during surgery," says Dr Praneel Ramchandra, a neurosurgeon who practises at the hospital.
His surgical team recently had to take a biopsy from a patient's basal ganglia, a structure situated in the base of the forebrain, which is associated with a variety of functions. A slight error while taking the biopsy could have had a number of serious implications for the patient, including a loss of motor control. However, the team was able to complete this highly complex procedure successfully, thanks to the clear, real-time images provided by the technology. "Such surgical accuracy would simply not have been possible without this system."
The hospital has acquired the most advanced version of the technology, in terms of both hardware and software, says Colin Grenfield, sales and marketing director of Surgical Navigation Technology, the local distributor of the system. According to Grenfield, the system incorporates cranial and spinal applications. This means that the system can be used for a great variety of procedures including brain tumour resections (the surgical removal of tumours), shunt and catheter placement, as well as spinal fusions, which are surgical procedures whereby two or more vertebrae are joined or fused. The system can also be used for selected ENT procedures.
"The technology works in a manner similar to a global positioning system (GPS) system in a motor vehicle. A radiological examination of a patient, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI), is saved on a CD and loaded onto the system. The patient's anatomy is then registered into the system and matched to the pre-acquired radiological examination. Once this is done, the system tracks a variety of surgical instruments, making it possible for the surgeon to know exactly where the tip of the instrument is positioned at any point in time. The surgeon is also able to determine precisely what anatomy lies in front of the instrument and plan the best pathway to the intended target destination. At the same time, critical pathways such as those commonly found in the brain, can be left undisturbed during a procedure."
Dr Ramchandra says there are a number of benefits to using the new system including improved accuracy when removing tumours in the brain or spinal cord. "We are able to remove more of the tumour with less damage to the surrounding tissue. What this means is that surgery is safer and morbidity rates are reduced. In addition, the technology usually enables less invasive procedures and cuts down on surgery time, thus reducing the risk of infection and complications. I find that because I know exactly where the tumour is when using the system, I am able to considerably reduce the size of the incisions I have to make to the skull cap to operate."
He adds that the technology also makes it easier to place shunts in the brain to drain fluid, as it provides an excellent view of the pathways in the brain. The technology also allows doctors to spot dangerous brain aneurisms more easily.
The hospital's GM, Louis Joubert, says the system's neuro navigation system is a major investment by the hospital in ensuring optimal outcomes for its neurology patients. "This sophisticated technology is assisting our specialists to treat a wide range of neurological conditions more effectively. It is also helping us to keep our facility at the forefront of medicine and make cutting edge neurological treatments available to the people of Pietermaritzburg and surrounding areas," he concludes.
