No Scalpel In Hand, Surgeons Treat Gamma Knife Patient

Nov 22 2007 - 11:33am
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Recently, Francis Gingras arrived at the University of Virginia Health System ready to undergo a form of brain surgery with many benefits. There's no scalpel, no risk of hemorrhage, minimal chance of infection and a good likelihood of success.

Gingras soon learned he was the 6000th patient of UVa's Lars Leskell Center for Gamma Knife Radiosurgery and one of the first to be treated with a new generation of equipment called the Perfexion.

"We're among a handful of centers around the world using the new Gamma Knife Perfexion," says Jason Sheehan, M.D., PhD, the center's associate director and an assistant professor of Neurosurgery and Radiation Oncology. Impressed by the equipment's advanced capabilities and expanded indications, he says it will help "provide optimal care to our patients."

During Gamma Knife procedures, neurosurgeons treat problems inside the brain without cutting open the skull. They use a single dose of radiation so precisely targeted that nearby normal brain tissue is preserved.

The Gamma Knife effectively treats tumors that arise in or spread to the brain as well as blood vessel defects and functional problems like trigeminal neuralgia and Parkinson's disease. The Perfexion represents a total redesign of the original Gamma Knife and has the potential to treat additional conditions. These could include tumors at the base of the skull and tumors and vessel malformations at the level of the cervical spine.

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Gingras, who resides in Johnson City, TN, suffers from a pituitary tumor that has caused him to develop Cushing's disease, a rare disorder that over-stimulates hormone production in the adrenal gland. When surgery and conventional radiation therapy failed to eradicate his tumor, doctors recommended Gamma Knife treatment.

At UVa, Gingras underwent a two-hour procedure focused on deactivating a small area of his tumor. Doctors are hopeful this will normalize his hormonal secretions. Gingras will return to UVa every six months to check his progress.

"I was comfortable throughout the entire process," he says. "I really cannot say enough good things about my Gamma Knife surgery experience and the entire UVa Health System. My wife and I don't mind the six-hour drive because we've been impressed by the people at UVa. My doctors really know what they're doing."

UVa's Gamma Knife Center is one of the most successful and experienced radiosurgery programs in the world. Since installing the world's fifth Gamma Knife 18 years ago, the center has attained global recognition as a pioneer and leader in its use. Besides offering the nation's only accredited advanced radiosurgical training course for physicians, the center's staff has produced many peer-reviewed publications, performed clinical and laboratory research, lectured worldwide and organized symposia that have drawn international participation. In the months ahead, the staff will explore additional indications for the Perfexion.

The director of the center is Ladislau Steiner, M.D., PhD, a professor of Neurosurgery and Radiology. A pupil and associate of Gamma Knife inventor Lars Leksell, he was involved in the development of the original Gamma Knife and its clinical application. Dr. Steiner has received many distinguished honors for his work, including the 2001 Surgita Award from the International Society for Neurosurgical Technology and Instrument Invention and the 2003 Gold Medal of Honor from the World Federation of Neurosurgical Societies.

Dr. Steiner calls the Gamma Knife "the gold standard of radiosurgery" and believes it will remain so, thanks to the Perfexion's key advancements. The new system, he says, is more comfortable for patients, completes treatments faster, and offers better dose planning - a capability that reduces radiation of surrounding tissue.

UVa's other leading Gamma Knife expert is Neal F. Kassell, M.D., professor of Neurosurgery. "Equipment like the new Perfexion is most effective when combined with experienced physicians," he observes. "Our staff is highly experienced and skilled in Gamma Knife procedures as well as conventional surgery. This enables us to objectively determine the best treatment for our patients. When it comes to the Gamma Knife, our broad experience translates into a higher degree of technical success and fewer complications. Patients know that by coming here, they're getting the best possible chance of a cure."

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