Dilatable Port for Deep Brain Access: A minimally invasive approach to remove brain tumor
Mirrah Almira - CMI Fellow
Introduction: A team of a physician and an engineer at the University of Pittsburgh has created a dilatable port to access deep brain tumor. This invention has great promise for a minimally invasive and less risky process for removing brain tumors.
[Pittsburgh, February 20, 2015] Early this year, American Cancer Society has estimated that there will be 22,850 new cases of nervous system tumors in 2015, with brain tumors accounting for almost 90% of the cases. In order to increase the survival rates of patients with brain tumors, maximal tumor removal is often needed. However, for cases where the tumor is located in the deep part of the brain, e.g. by the ventricles of the brain, the process of removing the tumor can be very difficult. When performing deep brain tumor removal, neurosurgeons are facing increased intra and post-operative risks. For example, the patient may develop brain hemorrhage and infection, have significant neurological deficit, and also suffer considerable morbidity after the tumor removal.
The surgical approach performed at most neurosurgery centers is the conventional aggressive dissection through many brain tissue layers to reach the tumor. The non-surgical approach is most commonly radiation therapy. Despite the fact that the patients would benefit from these procedures, the risks that are mentioned previously are still unavoidable.
A recent approach called "cylindrical endoscopic port surgery" appears to be less traumatic to surrounding brain tissue than conventional microsurgical dissection. This procedure has been used at the University of Pittsburgh Medical center (UPMC) and it is service-marked as NeuroendoportSM. In this procedure, rather than dissecting through many brain tissue layers, the tumor resection is performed with the help of a tube port. The inserted port enables the surgeon to visualize the anatomy surrounding the tumor, then internally de-bulk and remove the tumor mass. However, the NeuroendoportSM technique raises a concern for "shear injury" (a trauma that comes as a result of a tissue slides over another tissue) and it is still not able to mitigate the risk of retraction-related morbidity.
In order to solve this problem, a team led by a physician and an engineer at the University of Pittsburgh has created a dilatable port for deep brain access to improve the current treatments available for brain tumor removal. This new and patented (PCT/US11/54957) technology is a slender guide wire/balloon catheter system that can be inserted through the white matter to the tumor target. After reaching the target tumor, the tubular balloon is then slowly inflated, opening a cylindrical channel extending from the surgical opening site at the skull to the target. A clear tube is then inserted into the channel enabling neurosurgeons to access and perform surgery on the deep brain tumor. The catheter is also compatible with standard image-guidance technology, which will allow a great accuracy of the surgery. This dilatable port technology will decrease the possibility of shear injury and retraction-related morbidity.
The innovators behind this system consists of a physician and engineer team. They are:
Johnathan Engh, MD (Department of Neurological Surgery)
The $10,000 grant from CMI in 2014 has supported the team in reaching its targets. The team has been able to develop the prototype of the device by using a 3D print and an off-the-shelf balloon catheter. In the future, the team plans to focus on further development of the prototype and doing animal testing with imaging and postmortem examination to assess the effects of the new dilatable port.