Brain Tumor Surgery

Making the Inoperable Possible.

With best-in-class training, state-of-the-art technology and cutting-edge techniques, Neurosurgeons at the Gerald. J. Glasser Brain Tumor center safely operate on the most challenging brain tumors.

Neurosurgeons Dr. Yaron Moshel and Dr. Fabio Frisoli are experts in minimally invasive techniques and advanced brain mapping procedures that result in shorter hospital stays, faster recovery times and lower complication rates. Many patients leave the hospital in one or two days.

Caring for patients with brain tumors is complex, requiring the collaboration of many specialists. That’s why we developed an interdisciplinary team of specialists in brain tumor surgery, radiation oncology, neuro-oncology, neuro-radiology, neurology, neuro-pathology, nutrition, physiatry and social work. Together, we provide the most effective, safe and holistic treatment for the most challenging tumors.

In addition, at the Gerald J. Glasser Brain Tumor Center every patient’s case and story gets reviewed by a multi-disciplinary neuro-oncology tumor board where all the medical specialties work together to design the most effective individualized treatment plan.

Importantly, Drs. Moshel and Frisoli place every patient and family at the center of all treatment-related decisions.

 

Types Of Brain Tumor Surgery

3D-Image And Ultrasound Guided Stereotactic And Volumetric Tumor Resection
Using advanced surgical navigation and brain mapping technology, we perform precise surgery in the most minimally invasive way possible. Often referred to as neuro-navigation, computer-assisted technology tracks surgical instruments – including the operating microscope – during the operation. The system cross references the pre-operative MRI and intraoperative ultrasound, allowing our surgeons to visualize the borders of the tumor and protect the surrounding brain tissue. In conjunction with a team of neurophysiologists, we can determine “safe-entry zones,” protecting the areas of the brain that directly control function as well as the central nervous system.

Endoscopic Surgery
Endoscopes are long, narrow, flexible lighted tubes that provide a surgeon with light and visual access through small openings. We use preoperative MRI and CT scans to help plan these complex surgeries:

  • Endoscopic Port Surgery
    Using a small narrow tubular system, we perform surgery on deep-seated brain tumors through a small skin incision and opening in the skull. Using minimally invasive tubes that spread the white matter of the brain and are tracked by a computer navigation system, we gain access to deep seated brain tumors with minimal disruption to normal tissue. This technique results in a shorter hospital stay and fewer complications.

  • Endoscopic Skull Base Surgery
    Endoscopic skull base approaches are multidisciplinary surgeries that take advantage of the nasal passageways and sinuses to access the base of the skull without the need for an incision. These approaches – often performed in conjunction with ear, nose and throat surgeons – are appropriate for tumors at the skull base or upper spine, including meningiomas, pituitary adenomas, craniopharyngiomas, chordomas, and many others.
  • Endoscopic Ventricular Surgery
    Using an endoscope, we can access ventricles – fluid-filled cavities in the center of the brain that can be the site of many different pathologies – through a minimally invasive sheath, treating conditions such as hydrocephalus, colloid cysts and a wide variety of tumors.

Functional Brain Mapping

The brain is a highly complex organ that is unique to each individual. While each brain function maps to a general area, their exact location deviates from patient to patient. Advanced brain mapping allows us to precisely remove brain tumors without damaging surrounding brain matter … providing the best long-term outcomes. These types of surgeries include:

  • Awake Functional Brain Mapping
    Awake brain mapping allow us to remove as much of a brain tumor as possible while minimizing the impact on areas that control movement, sensation and speech. During surgery, the patient is awake and interactive, helping surgeons and neurologists understand and map out the functional areas of the brain near the tumor. This allows a tumor to be removed with minimal disruption to healthy critical brain tissue.
  • Electrophysiological Motor and Sensory Mapping
    To perform awake and even asleep functional brain mapping during surgery, we use electrical currents to stimulate specific brain areas or nerves, eliciting a motor response from the body or a sensory response within the brain. This ensures motor and sensory systems are identified and preserved.
  • Advanced Imaging including functional MRI, Diffusion Tensor Imaging (DTI)
    We use advanced imaging prior to surgery to study the location of a brain tumor and surrounding critical brain areas – as well as simulate surgical approaches. Brain mapping using a functional MRI scan enables us to visualize the exact location of critical brain functions in relation to a tumor. DTI imaging allows us to see the pathways within and among different brain areas, ensuring minimal disruption to other areas.

Frameless Stereotactic Needle Biopsy

A biopsy – versus surgical resection – is recommended for some tumors. During a biopsy – often done through a tiny incision and a small needle guided to the target in the brain by an optical computer system – a small core of the tumor is sampled, and the tissue is diagnosed.

Leading the Way in Advanced Brain Tumor Surgery

  • Atlantic Brain and Spine neurosurgeons at the Gerald J. Glasser Brain Tumor Center perform more brain tumor operations than any other center in the state.

  • The team uses the latest, most advanced techniques – including neuro-navigation, endoscopes and minimally invasive tubes for deep seated lesions – to precisely plan and perform the least invasive surgeries.
  • A highly specialized team includes neuro-anesthesiologists and neuro-physiologists who ensure each patient receives optimal anesthesia and neuro-monitoring during surgery.

  • We perform awake brain surgery for lesions located in areas that directly control bodily functions.

  • Our surgeons often perform surgeries on tumors others deem inoperable – with successful outcomes.

Brain Tumor Surgery Specialists

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