Everyone knows about operating rooms, but you might not be familiar with operating…vans.
That’s because the new Mobile Operating Room Experience (MORE) has just been introduced. Columbia neurosurgeon Dr. Marc Otten conducted the inaugural course in the MORE lab.
The spacious MORE lab is set up as a teaching theater. Its eight separate lab stations allow students to get a lot of hands-on experience. The equipment is provided by medical device company Stryker, so it is exactly what surgeons might find in a normal operating room.
For Dr. Otten’s course, called “Endoscopic Approaches to the Skull Base,” each lab station was equipped with a specialized endoscope. An endoscope is a tiny camera and light at the end of a thin tube. Images from the endoscope are displayed on a monitor for the surgeon (see photo above).
Dr. Otten taught neurosurgeons-in-training how to use the endoscopes for specific approaches and techniques for brain surgery. Before the hands-on portion, Dr. Otten conducted a thorough review of anatomy. But not just anatomy of the brain–anatomy of the nasal cavity and sinuses.
It’s because endoscopes are used in minimally invasive surgery. A surgeon using an endoscope doesn’t make any external incisions to expose the brain. Instead, he or she simply places the endoscope through the nostrils, and accesses millimeters from the brain, before any incision is made.
“It was wonderful to see the residents learn how to use the endoscope,” says Dr. Otten. “It’s a gifted group, and they quickly pick up new techniques.”
And the course was useful for doctors who are interested in all approaches, not just minimally invasive techniques. “Even for residents who won’t be doing much endoscopic skull base surgery, approaching the brain through the nose reinforces their knowledge of anatomy, which they are accustomed to seeing from trans-cranial [through the skull] approaches. Having a picture in their minds of the brain from all angles, they will become safer surgeons, whatever their approach.”
Dr. Otten himself performs both traditional and minimally invasive surgery. He prefers the endoscopic approach for particular surgeries, though. “[Endoscopic surgery] may provide a better way of removing certain kinds of tumors, such as pituitary adenomas, meninigiomas, craniopharyngiomas and chordomas,” he explains.
Dr. Otten is highly trained in traditional, minimally invasive and non-operative approaches. He notes that he is fortunate to have access to a variety of options. Depending on the situation, he may use the endoscope, the Cyber Knife, the Gamma Knife, or other equipment. “It is rare for a surgeon to have access to all of the modalities – Columbia is a special place,” he says. He treasures the ability to use the best approach for whatever job is at hand. And he enjoyed the chance to share his expertise with so many residents at once.
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