Pittsburgh, October 11, 2005 -- A new operating room designed solely to accommodate a novel surgical procedure for removing brain tumors through the nose opened recently at UPMC Presbyterian. This facility, called the Endonasal Surgical Suite, is believed to be the first of its kind in the United States.

The operating suite is the result of collaboration between UPMC and Karl Storz Endoscopy-America Inc., which worked closely with surgeons at the University of Pittsburgh in its design. The suite maximizes the benefits of minimally invasive surgery to patients and surgeons by using the latest electronic control systems to seamlessly integrate devices and the many environmental components of the room including lighting, operating room tables, endoscopic equipment and cameras.

The surgical technique, called Endoscopic Transnasal Brain Surgery, also known as expanded endonasal approach (EEA), was refined by UPMC surgeons and represents an advancement in surgeons’ abilities to remove benign and malignant tumors, some as large as baseballs. After the surgery, in many cases, patients are discharged within a few days. The surgery has the potential of reducing lingering side-effects.

The traditional surgery to remove these tumors, called a craniotomy, requires accessing critical areas of the brain by carefully peeling away the skin of the face and cutting open the skull.

“The procedure allows both the approach and removal of the tumor to be done with minimal disturbance to surrounding tissues. We can access large tumors without manipulating the brain and minimize touching normal tissue. We feel there is a potential for less damage to brain and nerve tissue and a potential for faster recovery and hospitalization,” said Amin Kassam, MD, associate professor of neurological surgery and co-director of the Minimally Invasive Cranial Base Center.

Patients with malignant cancers can benefit greatly from the endonasal approach because they can start chemotherapy or radiation treatment almost immediately, giving the drugs a chance to work before the tumor returns.

“One of the drawbacks of conventional surgery for cancerous brain tumors is that by the time the surgical wounds heal sufficiently for follow-up treatment, the doctor’s surgical handiwork may be undone by tumor re-growth,” said Carl Snyderman, MD, professor in the department of otolaryngology, and co-director of the center.

The UPMC/Karl Storz collaboration also has led to the fabrication of special endoscopic instruments to see inside the skull, drills to gain access and tools to remove the tumors without damaging delicate blood vessels or nerves. Surgeons also use computerized mapping systems similar to GPS that enable them to navigate the brain through the nasal opening.

“The technology brought together in this room allows us to navigate deep inside the brain in ways that were once thought impossible and operate with greater confidence to ensure the best surgical outcome for the patient,” Dr. Kassam said.

The main features of this futuristic operating room are the powerful electronics that allow for unsurpassed connectivity within the room. These are linked to physicians’ offices, the observation gallery, the boardroom and via the internet to distant locations. Data sources include digital video from the endoscope, the microscope, the image guidance system and room cameras. The room is specifically designed to capture high quality digital video from the surgical endoscope and display it on monitors suspended from the ceiling. The images also are sent to large plasma screens within the operating room and in the observation gallery.

A telestration system, similar to that used by commentators during televised football games, allows the surgeon to highlight anatomical structures of interest on the screen and facilitates intraoperative communication and teaching by providing real time remote feedback on all the operating displays. Using this device, the surgeon can guide the surgery, discuss the surgical plan or teach. Numerous cameras are mounted throughout the suite and are connected by two-way voice technology to facilitate live lectures, didactic courses or real-time cases to or from remote sites.

Each year, UPMC surgeons teach approximately 100 doctors from around the world how to perform endoscopic surgery of the cranial base, using the new operating room for a live surgery demonstration followed by classroom and laboratory activities.