New Surgery at Sentara Norfolk General Hospital
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New Surgery at Sentara Norfolk General Hospital 

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Norfolk, VA – April 21, 2008 – Surgeons at Sentara Norfolk General Hospital are the first in the area to remove a brain tumor through their patient’s nostril. Brain tumors, mostly those affecting the pituitary gland, are ideally positioned just behind the nose for this advanced surgical technique.

The first part of the surgery is done by a skillful ear, nose, and throat surgeon who navigates the sinus cavity allowing direct access to these skull-based tumors. Using an endoscope—tubing with a light and lens attached—neurosurgeons at Norfolk General then get a panoramic view of the brain. With a more complete view, surgeons can remove the entire tumor in most cases.

Since the endoscope is passed through the patient’s nostril, no incision is required. The new technique, much shorter than the traditional surgery, means no nasal packing and little pain. Most patients go home within 48 hours. This advancement contrasts sharply with the traditional approach.

Before, a patient with a pituitary tumor would have endured at least a four-hour surgery where an incision was made through their gums. Other tools would be snaked into position under their face, and a microscope would be used to view the tumor. Since the microscope had limited movement, seeing the entire tumor would be difficult.

Patient Story
For 62-year-old Ted Christian, whose temporary vision loss was attributed to a pituitary tumor, there was a silver lining. After researching his options, he found that the new, less invasive procedure was done at Norfolk General.

“I was very comfortable with all of the resources here,“ Christian said. “The doctors are very skillful and confident, and they had a way of making me very comfortable,” he continued.

“Now people can stay closer to home, when before they may have left the area for this expertise,” says Dr. Joseph Han, ear, nose and throat surgeon who has done about a hundred of these cases during his career. “A study we’ve just completed now proves what’s been suspected for some time. Patients who have this procedure done endoscopically versus the traditional surgery do experience less pain, shorter stays, and much less bleeding,” continues Han.

Called natural orifice surgery, this technique goes a step beyond minimally invasive surgery. Doctors around the country are beginning to use the body’s natural passageways—like the sinuses — as the most direct route to some tumors, glands, and organs. With much less cutting required, this new surgical option often dramatically improves outcomes and overall recovery time.

“I went home within 24 hours with absolutely no pain. It was quite incredible that I felt that good so soon after surgery,” Christian said.

This new surgery, visible live over the internet Thursday, May 8 from 3 to 4 p.m. launches Sentara’s 2008 live surgery series. Watch the surgery as it happens or view the archives later at a more convenient time. Dr. Joseph Koen, a neurosurgeon who also performs this procedure will serve as moderator during the live webcast. Drs. Joseph Han, an ear, nose, and throat surgeon and associate professor at Eastern Virginia Medical School, and Ran Vijai Singh, neurosurgeon, will perform this innovative surgery from an operating room at Sentara Norfolk General Hospital.

Drs. Han, Singh and Koen were involved in a local study whose findings are being presented at the 2008 American Rhinologic Society/Combined Otolaryngology Spring Meeting (April 30-May 3, 2008).


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