Issue link: https://tmcpulse.uberflip.com/i/1125769
t m c » p u l s e | j u n e 2 0 1 9 34 Virtual Platforms Help Surgeons Plan Ahead More thorough preparation means better post-operative results B y C i n d y G e o r g e I nnovation allows surgeons to virtually step inside the human body and prepare for complex procedures, from plotting the precise location of a brain tumor to exploring the intricacies of a child's malformed heart. Before neurosurgery at Houston Methodist Hospital, physician Gavin Britz dons black wraparound goggles to strategize amid virtual reconstructions that combine CT scans, MRIs and surgical navigation into one 3D visualization platform. He can start outside the patient's skull, pan inside an eye socket into the brain's soft tissue and locate a tumor amid the tangles of vascu- lature. Thanks to technology, the tumor appears fluorescent, which makes it easier to find. The visualization platform, Surgical Theater, is used in about 50 medical centers and academic insti- tutions around the world. Houston Methodist has the only system in Texas, according to Brady Culbreth, the company's Houston-based pro- gram lead. Houston Methodist paid about $800,000 for the technology, a hospital system spokeswoman said. Britz, a brain and tumor neuro- surgery specialist who is chair of Houston Methodist's neurosurgery department, said his field is steeped in tech out of necessity. "Fifty years ago, a patient presents with headaches. You know they have a tumor. You have to inject into the head or into the spine. You think the tumor is there. You have to operate on the patient not knowing. You think the tumor is on the left- hand side based on the examination. That's guesswork," he explained. "You go in the head and you're probably a couple of centimeters wrong. You can imagine the disaster. So, technology in neurosurgery has really made things safer and is a great equalizer." For Britz and other neurosur- geons, 3D visualization is a major breakthrough. "I can get within a few millime- ters of where the tumor is," Britz said. "Just because I'm in Texas doesn't mean I'm a cowboy. You have to be a thoughtful surgeon. The more I plan pre-operatively, the better your results are post- operatively. Technology has allowed us to really understand the disease process—where it is and how you can approach it surgically." The technology also transforms the patient experience. According to the Ohio-based Surgical Theater, the visualiza- tion platform "allows patients and their surgeons to step into the patient's complex diagnosis and to walk together in a 360-degree, virtual reality reconstruction of the Using a representation of a patient's brain, Houston Methodist neurosurgeon Gavin Britz, MBBCh, MBA, MPH, demonstrates how he navigates the brain using 3D wraparound goggles and the Surgical Theater system. Just because I'm in Texas doesn't mean I'm a cowboy. You have to be a thoughtful surgeon. The more I plan pre-operatively, the better your results are post-operatively. Technology has allowed us to really understand the disease process—where it is and how you can approach it surgically. — GAVIN BRITZ, MBBCH, MBA, MPH Chair of the Houston Methodist department of neurosurgery v i s u a l i z a t i o n