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Neurosurgeons using laser technology to eradicate brain tumors

| Monday, Nov. 9, 2015, 9:00 p.m.
Justin Merriman | Trib Total Media
Linda Fahey, 65, of Cannonsburg had a procedure at Allegheny General Hospital that utilized the Visualase system, a minimally-invasive laser surgical technique to remove a brain tumor in October.
Heidi Murrin | Trib Total Media
Dr. Khaled Aziz with computer images of the Visualase Therapy System Thursday, Nov. 5, 2015 at Allegheny General Hospital. The system is an MRI-guided minimally invasive laser ablation system that uses light energy to target brain tumors.
Heidi Murrin | Trib Total Media
Computer images of the Visualase Therapy System , which is an MRI-guided, mimimally invasive laser ablation system that uses light energy to target brain tumors. At left, is the laser delivering heat to a brain tumor. At right, is at the end, when the right dose has been determined.

The brain tumors kept recurring, and Linda Fahey was out of options.

At 65, she had undergone chemotherapy and four craniotomy procedures, in which surgeons peeled back a portion of her skull to access her brain and remove the tumors.

When a fifth tumor surfaced, Fahey's oncologist told her she might not properly heal from another craniotomy.

Fahey's neurosurgeon, Dr. Khaled Aziz of Allegheny General Hospital, proposed an alternative: new laser technology that could burn away the tumor.

In mid-October, Fahey of Canonsburg became the first patient in Allegheny County to undergo a process known as laser ablation. The process enables surgeons to destroy brain tumors and lesions with pinpoint precision and allows patients to avoid conventional invasive surgery.

Aziz performed the procedure by poking a tiny incision in Fahey's skull and inserting a probe, about the size of pencil lead. Guiding himself with MRI images, he used a laser to burn away the tumor cells.

Aziz performed all four of Fahey's craniotomies.

“Every time I did the surgery, the picture initially looked clean, but the tumor came back,” he said. “Luckily, the laser option was on the horizon, and she fit the profile. So far, it has been utilized for patients who failed surgical treatment and failed chemotherapy.”

Instead of a large incision that comes with most brain surgeries, laser ablation leaves a tiny incision that can be closed with a 1-inch suture.

“I truly feel like I was in the right place at the right time,” Fahey told the Tribune-Review. “When you go in for surgery of the brain four times, you have to face the possibility that you might die. I was ready to try this new treatment and felt like, ‘If this is my time, it is my time; I am OK with it.' ”

Recovery times can be much shorter than with traditional surgery. Fahey, who is married with four children, left Allegheny General a day after the operation and said she's fully recovered.

“My family and I were, of course, pretty scared to try something new,” she said. “But there was really no other choice. We're all grateful that I have more time. It's incredible how far medicine has come.

“I really appreciate that Dr. Aziz took this training and stayed up on the research. If he didn't, who knows whether I'd be here today.”

On Nov. 18, Aziz is scheduled to perform two laser ablations using the system known as Visualase, designed by Medtronic Medical Technologies, headquartered in Minneapolis and Dublin, Ireland. Dr. Alexander Yu, another AGH neurosurgeon, will assist him.

Doctors across the country are using the system. Approved by the Food and Drug Administration, it costs around $250,000. About 1,000 neurosurgery patients in 50 medical facilities have benefitted from the technology.

“It's exciting. This was the first one done by me and the first one done in Pittsburgh,” said Aziz, who took a training course to learn how to use the laser system. “It's a much less invasive procedure.”

UPMC plans to test the technology to treat brain tumors and destroy brain tissue that potentially causes epileptic seizures.

“It's potentially an important technology we can add,” said Dr. Mark Richardson, director of epilepsy and movement disorders surgery at UPMC. “We are looking forward to evaluating it.”

In addition to Visualase, UPMC will test a system called NeuroBlate, designed by Monteris Medical of Plymouth, Minn.

Fahey, a retired reading teacher for the Department of Defense, said she's feeling pretty good for someone who survived five brain surgeries.

“I'm moving a little slower, but I can read complicated material and understand it and have lengthy conversations,” she said. “I still have all my thinking intact.”

At the conclusion of the October operation, which was captured on video, Fahey looked up at the surgical team, smiled and thanked them.

“I love you Dr. Aziz,” she said.

Ben Schmitt is a Trib Total Media staff writer. Reach him at 412-320-7991 or bschmitt@tribweb.com.

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