Taking surgery to a new level

Placing MRI into operating room benefits patients


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Everyone thought Dr. John Saunders was crazy. It was 1993, and Winnipeg neurosurgeon Dr. Garnette Sutherland went to Saunders with a problem.

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Hey there, time traveller!
This article was published 12/10/2010 (4325 days ago), so information in it may no longer be current.

Everyone thought Dr. John Saunders was crazy. It was 1993, and Winnipeg neurosurgeon Dr. Garnette Sutherland went to Saunders with a problem.

Sutherland had recently operated on a young girl who had 10 tumours in her brain. He thought the operation had been a success, but an MRI scan later revealed Sutherland missed a section of tumour and the child would have to undergo another onerous surgery.

Saunders said his longtime research partner told him he needed an MRI in the operating room to look at what was going on inside the patient before surgery ended. At the time, his options were limited.

WAYNE.GLOWACKI@FREEPRESS.MB.CA Sally Flintoft, president of the Health Sciences Centre Foundation, visits the area under construction where the IMRIS intra-operative MRI will be installed at the HSC. The device will allow a patient to be scanned while still on the operating table.

Surgeons in Boston were using a double-donor system, where the surgeon was in the machine with the patient but had limited mobility. In parts of Germany, patients with their brains exposed were wheeled from the operating room to another location to have an MRI scan.

Saunders, a chemist by training, said he felt the only safe way to do it was to put the MRI near the operating table. Within months, the National Research Council scientist uprooted from Ottawa to Winnipeg, and started work on a groundbreaking technology that has since been used on more than 4,000 patients around the world in hospitals as far away as India, China, Australia and parts of Europe.

“I could tell you that every physicist I spoke to and every business I spoke to told me I was crazy,” Saunders said. “I was moving a mountain to a man, whereas normally people move a man to a mountain.”

Next spring, the technology that was developed here and built by a Winnipeg company, IMRIS Inc, is finally coming home.

Saunders, Sutherland, and a team of research scientists helped patent an intra-operative MRI that comes into the operating room to scan a patient during surgery.

The “magnet,” as scientists call it, will be one of the showpieces in the Centre for Surgical Innovation, part of the 80,000-square-foot Kleysen Institute of Advanced Medicine that is still under construction at Health Sciences Centre.

The building will use experimental technology on patients. It’s already home to a PET/CT scanner and the Artiste, a non-invasive therapy that delivers targeted radiotherapy to cancer patients.

The first intra-operative MRI for brain surgery was installed in a Calgary hospital in 1997. HSC will be the first hospital in Canada to also use the intra-operative MRI for neurovascular conditions, to promptly identify stroke patients who are likely to benefit from immediate intervention.

Saunders said the technology allows doctors to see the structure of arteries and assess the condition, during and after, of patients who have suffered aneurysms and other vascular conditions.

HSC Foundation president Sally Flintoft said until now, Winnipeg has not had the facilities to accommodate the technology. Construction of the second floor of the Kleysen Institute alone, where the Centre for Surgical Innovation is housed, cost $25 million.

Right now, the MRI’s future home is just a shell with a web of metal pipes snaking around its floors and copper foil flanking its walls. By April 2011, the machine will be sandwiched between the neurosurgery operating room and neurovascular operating room.

During the procedure, surgeons will need to remove all of the metal surrounding the patient. The surgeon and radiologist will monitor the scan from an adjacent room, as the “garage doors” open and the magnet wheels out along metal tracks. It hovers above the operating table and gets a snapshot of what’s going on inside the patient. The patient never leaves the operating table.

“Literally, the doors slide open and the magnet rolls along the train tracks,” said Flintoft.

“For them to be able to image immediately is very powerful. You get in here and you may not see everything because there’s a blood clot or a piece of tissue.”

Flintoft said the technology could put an end to the days when surgical patients had to go back for another round of surgery. It will be less taxing on the patient and more efficient for health care.

For now, the procedure will be used on neurosurgery patients undergoing procedures such as deep-brain stimulation, where a surgeon implants a device that emits electrical impulses to treat tremors, dystonia or Parkinson’s disease.

Between 2009 and 2010, HSC saw 900 neurosurgery patients.

“It’s good for patients, it’s good for surgeons, for us it’s very rewarding,” said Saunders, who is the chief scientist at IMRIS.

Flintoft said the hope is that as surgeons discover the tool’s capabilities, it can be eused in other areas of medicine. “This is just the beginning.”




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