Sunday, June 20, 2010

Faster than a speeding action potential

New York is the city that never sleeps and--after my first week of Summer Immersion--I certainly believe that statement applies to Dr. Theodore Schwartz, the neurological surgeon I have been following this week. He specializes in treating pituitary tumors, epilepsy, and meningioma, among other diseases. Thus far I have only been fortunate enough to witness one surgery, and a very impressive one at that. This past Wednesday morning (6/16) I observed a team of surgeons headed by Dr. Schwartz remove a pituitary tumor from an older patient. On the surface this does not sound too hard right? Just open up the patient and cut it out. Not quite. The pituitary gland is located at the base of the skull, making it extremely difficult to access surgically. In order to access these inconvenient locations, surgeons make use of endoscopic technologies. Endoscopes are basically long, thin flexible tubes with a camera or imaging device mounted on the tip. The resulting images are then displayed on large monitors, giving the room a great view of whats going on. In this case, endoscopes were inserted through the patients nose and sinus cavities in order to gain access to the tumor. In conjunction with the endoscope, a variety of other tools were used to dissect away the tissue between the sinus cavities and the pituitary tumor, which was cut into smaller pieces and removed. The bulk of the surgery (endoscopes inserted in the nose) lasted about three hours. Both 2D and 3D endoscopes exist, the latter requiring some stylish glasses. The surgical team made use of the 3D scope for a portion of the surgery, but it seemed that the choice between using 2D and 3D is largely a taste/technique issue—some like the extra dimension, some don't. On a more personal note, I had never been inside a bustling operating room before (aside from when I was being operated on). I was surprised by how everything seemed very routine, and I learned that some surgeons often work best when there is music playing in the room. It would be interesting to see what most surgeons prefer to hear, and if they can provide their patients with the soundtrack to their surgery as a parting gift.

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