Astonishing recovery after minimally invasive brain surgery
After being diagnosed with a brain tumour on his pituitary gland and being told surgery was too risky, John Fairchild was facing blindness and possible death. Minimally invasive brain surgery at The Ottawa Hospital restored his sight and his future.
Category: Creating Tomorrow
After experiencing vision problems, severe headaches, and repeated transient ischemic attacks (TIA’s) –mini-strokes, John Fairchild was diagnosed with a tumour on his pituitary gland. With each TIA being potentially fatal or causing paralysis, and with surgery being high-risk, John began making detailed plans to help his wife carry on without him.
That was until September 2015, when minimally invasive brain surgery at The Ottawa Hospital saved his life.
In 2011, John had been told by a doctor in Edmonton that he had a tumour in his pituitary gland and the operation to remove it was too risky. The doctor advised him to wait several years until the procedure had been improved.
Five years later, John and his wife Suzanne had moved to Ottawa, and he was having regular TIA’s. During these mini strokes, his vision was reduced to seeing through a small hole, and his memory and speech were impaired. The 71-year-old was referred to see Neurosurgeon Dr. Fahad Alkherayf at The Ottawa Hospital. Dr. Alkherayf recommended John undergo the newly available minimally invasive brain surgery. With this technique, his tumour, which was benign, would be removed through his nostrils instead of the traditional more radical and risky surgery, which required opening up his skull.
The benefits of minimally invasive brain surgery
“It is a new field in neurosurgery,” said Dr. Alkherayf, who has advanced minimally invasive brain surgery techniques in recent years. “There are no incisions in the skull, no cut in the skin. Everything is done through the nose.”
This operation is safer with surgery time greatly reduced. It means patients not only spend less time in the operating room, but they go home sooner. They experience less complications and better recovery.
John Fairchild at home following his surgery
Vision and hope restored
“I believed there was some risk of being blind or dead after the operation, as it was so new,” said John. “I spent two months before the operation, training to carry on being blind. I taught my wife how to use the snow blower and handle the finances.
“When I opened my eyes in the recovery room, I could see a clock on the wall, and I could see the time! I wasn’t blind.”
— John Fairchild
The Ottawa Hospital is a North American leader in this procedure.
“We have been asked for consultations internationally,” said Dr. Fahad Alkherayf. “It’s a very exciting technique that has definitely improved patient care during these surgeries.”
A bright future
In the year since the operation, John has resumed his active life.
“Thanks to The Ottawa Hospital’s virtuoso surgery team, I am again now in vital good health – curling, skiing, golfing — with excellent vision and no headaches. I am extremely grateful for the extraordinary care I received in the hospital, and wonderful after-care.”
“I am so well now, you’d never know anything was ever wrong with me. I am very proud of the hospital and the medical team. You guys saved my life.”
— John Fairchild
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Innovation and Technology, Innovation and Technology, Innovation and Technology, Innovation and Technology, Neuro, Neuro
Originally published: July, 2019 Updated: August, 2022
Update: Recently, June had to go back on hemodialysis after complications of being on peritoneal dialysis for eight years. As she awaits another kidney donor, June continues to watch her family grow. She now has four grandchildren, two girls and two boys. In August 2022, we were thrilled to announce a $10-million gift from the Jones family to the Campaign to Create Tomorrow. Read more about their incredible gift.
June Jones lives a double life. During the day, she is busy, making cookies with her two granddaughters, working in her garden, and enjoying life. During the night, she sleeps hooked up to a dialysis machine. June needs a new kidney.
June making cookies after Christmas with her granddaughter.
The 58-year-old has been living with kidney disease for 30 years — over half her life.
In April 1989, not long after her second child was born, June felt extremely run down. Her physician was concerned she had too much blood in her urine and sent her to a nephrologist.
He diagnosed her with IgA nephropathy, disease caused by her body’s immune system attacking her kidneys.
June started on various medications after being diagnosed, but within nine years her disease had progressed, and her kidneys stopped working completely. She started dialysis in 1998.
“There is no cure for renal disease,” said June. “Once your kidneys fail, you’re put on dialysis or have a transplant. Your life is never normal.”
What kidneys do
The function of the kidneys is to remove waste and extra water from the blood to make urine. When kidneys stop working and no longer clean the blood, toxins accumulate in the body, and this can be fatal. Dialysis is an artificial method of cleaning the blood. It sustains a person’s life but is not a cure.
There are two different forms of dialysis. Hemodialysis removes waste products and extra water from the blood by circulating and filtering it through a machine. This is the most common form of dialysis that is often provided to patients at the hospital. Peritoneal dialysis circulates a fluid through the lining of your abdomen, or peritoneum, and the waste products from the blood pass into this fluid.
There are almost 1,000 patients on dialysis in the Ottawa area. Just over two hundred are on peritoneal dialysis. Dr. Brendan McCormick, Medical Director of the Home Dialysis Program, said some patients have been treated for over a decade on peritoneal dialysis but more typically patients spend about three years on this therapy. People leave peritoneal dialysis once they receive a kidney transplant, however, some need to transfer to hemodialysis due to complications of therapy.
The Ottawa Hospital Home dialysis program has the highest rate of kidney transplant in the province. For many patients, peritoneal dialysis serves as a bridge to kidney transplant.
Needing life-saving dialysis
According to a report by the Canadian Institute for Health Information released in December 2018, only 16 percent of Canadians on dialysis survive past 10 years. However, up to 74 percent of Canadians with a kidney transplant still have a functioning kidney after 10 years.
June was only on dialysis for six months before she received the call that a donor match had been found. On November 28, 1998, June received a kidney transplant from a deceased donor.
“It lasted four months shy of 15 years,” June said. “Then, the disease reappeared. I’ve been back on dialysis now for six years.”
In the Ottawa Region, 52 people have received kidney transplants this year. Unfortunately, there are still 165 people are on a waiting list.
“We need to do a lot of transplants to get people off dialysis to keep them alive longer with a better quality of life,” said Dr. Ann Bugeja, nephrologist and Director of the Living Kidney Donor Program. “We know that getting a living donor kidney is the best treatment for end-stage kidney disease and it lasts longer than getting a kidney from a deceased donor.”
When June’s kidney transplant failed six years ago, she had to go back on hemodialysis. She switched to peritoneal dialysis in July 2013. Once again, she has a dialysis machine at home, but this time she does dialysis for nine hours every night. It cleans her blood while she sleeps.
June’s nightly routine is a hassle and not a permanent solution. The membrane around her stomach has started to harden, which means the fluids can’t move back and forth as easily. What this means is that June will have to go on hemodialysis. The technology hasn’t changed in the 20 years since she was on it before and she remembers too vividly how it gave her severe headaches and was painful.
Making a difference for future generations
Russ and June Jones with their family at The Ottawa Hospital. The Jones family made a $1 million donation to support kidney research at The Ottawa Hospital.
June needs a new kidney. She is on a Canada-wide waiting list for one.
“Giving a kidney can change somebody’s life,” said Dr. Bugeja.
June lives with the daily hope of a second transplant.
She and husband Russ know first-hand how important research is to improve outcomes for people suffering with kidney disease. They heard researchers at The Ottawa Hospital were making great strides finding solutions to kidney diseases, including detecting kidney disease early and looking at the potential of stem cells to heal injured kidneys.
They decided the only way to make a difference for future generations of patients was through research and made a $1 million donation to support kidney research at the Kidney Research Centre at The Ottawa Hospital.
Their support will enable the research team at the Kidney Research Centre to continue to advance knowledge and improve the care of patients with kidney disease through world-renowned studies and research.
June’s children are now adults, married, and parents themselves — each with their own adorable little girl.
On January 8, 2019, the entire family was at The Ottawa Hospital Kidney Research Centre to unveil a plaque outside the Jones Family Foundation Kidney Research Laboratory. The plaque commemorates their incredible support of kidney research.
“I hope with research advancements, I will live to see my grandchildren’s memorable events,” said June.
“I hope to be there for their high school graduations, university graduations, their wedding days, and when they have children of their own. I also hope great strides are made so that their generation will find a cure.”
Listen to Pulse podcast and hear June Jones in her own words explaining what it’s like waiting for a second kidney transplant and why research is so important.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Donors, Kidney, Patient Care
Published: June 2019
Heather Harris was driving her fiancé to a golf tournament one morning in 2001 when her right foot went numb. By the end of the day, the numbness had spread up the entire right side of her body.
The then-24-year-old Thunder Bay resident had an MRI, which showed signs of multiple sclerosis (MS). The numbness was her first MS attack.
MS is a devastating disease that occurs when the immune system—which protects against foreign organisms such as viruses or bacteria—mistakenly attacks the body’s own central nervous system, which includes the brain, spinal cord, and optic nerve.
Heather Harris preparing herself prior to her transplant operation.
Heather met with neurologist and MS specialist Dr. Mark Freedman just a few weeks before her wedding. Heather’s disease was progressing rapidly. Dr. Freedman told her she would be in a wheelchair within five years.
Dr. Freedman and hematologist and scientist Dr. Harold Atkins were leading a world-first clinical trial, investigating whether patients with early, aggressive MS would benefit if their immune system was wiped out with high-dose chemotherapy and then regenerated with blood stem cells.
The stem cell treatment seemed her only hope. Heather and her husband moved to Ottawa for a year while she took part in the trial. She had the stem cell transplant in November 2006.
“It’s now 12 years since my stem cell transplant. I really feel like I’m cured,” said Heather who has no symptoms of the disease. She works full-time as a school principal, and is back to camping, skiing, running and driving a manual shift car.
Heather and her husband wanted to have a baby. With the help of in vitro fertilization, Heather had a baby girl in 2016. She said her little Zoe is the second miracle in her life.
In June 2016, Drs. Freedman and Atkins published the results of their successful clinical trial in The Lancet, a top medical journal. To date, more than 50 MS patients, like Heather, from all over Canada have undergone this treatment, which eliminated all signs of damaging active brain inflammation.
MAY 26, 2019, OTTAWA, ON – Close to 600 runners laced up their running shoes to support The Ottawa Hospital at Tamarack Ottawa Race Weekend. Together, they raised $296,060 by choosing to Run for a Reason and support an area of The Ottawa Hospital close to their hearts.
Since 1998, Run for a Reason has united individuals and teams, family, friends and employees of The Ottawa Hospital for one common cause—to support eastern Ontario’s most important health care hub. Funds raised will help transform patient care and advance research.
Nora Shipton returned as team captain of Preemies 4 Preemies this year. Her team raised funds for The Ottawa Hospital’s neonatal intensive care unit. She loved the experience of being part of something special that brought so many of her family and friends together. “I can’t wait to do this again next year. We had a lot of excitement on our team and it feels heartwarming to have so many people come out and support us.”
It’s this kind of community support, which makes Run for a Reason such a special fundraiser for The Ottawa Hospital. Tim Kluke, President and CEO of The Ottawa Hospital Foundation, said he sees it year after year. “The energy never disappoints. I know for each participant, whether they ran or walked, there is special meaning behind why they are fundraising for The Ottawa Hospital. These are our ambassadors who will leave a lasting legacy as we continue to make significant strides in research and patient care.”
“These are our ambassadors who will leave a lasting legacy as we continue to make significant strides in research and patient care.”
Tim Kluke, President and CEO of The Ottawa Hospital Foundation
The Ottawa Hospital is one of Canada’s largest learning and research hospitals, with more than 1,200 beds, approximately 12,000 staff members and an annual budget of about approximately $1.3 billion.
Our focus on learning and research helps us develop new and innovative ways to treat patients and improve care. As a multi-campus hospital affiliated with the University of Ottawa, we deliver specialized care to the Eastern Ontario region and our techniques and research discoveries are adopted around the world. We engage the community at all levels to support our vision for better patient care.
From the compassion of our people to the relentless pursuit of new discoveries, The Ottawa Hospital never stops seeking solutions to the most complex health-care challenges. For more information about The Ottawa Hospital, visit ohfoundation.ca.
They were born at The Ottawa Hospital on December 22, 2006, three and a half months premature. Rhys was 1 lb 8 oz, his identical twin Cullen was 1 lb 4 oz, brother Liam was 1 lb 10 oz, and his identical twin Daniel was 1 lb 3 oz.
“We knew it was quadruplets when I had the first ultrasound at eight weeks. There were four heart beats,” said Nora Shipton, the boys’ mother. “We had two sets of identical twins born by caesarean section. There was an amazing team of 25 people in the delivery room.”
The boys were born exceptionally early at 26 weeks and two days. Babies born before 35 weeks are considered high risk—their lungs and hearts aren’t fully developed yet.
Specialized Care at The Ottawa Hospital
Liam and Rhys at 2.5 months old
When the White quadruplets were admitted to the Neonatal Intensive Care Unit (NICU) at The Ottawa Hospital’s General Campus, making sure they kept breathing was critical. Liam didn’t need a tube to open his airway but received oxygen through a nose tube instead. The other three boys, however needed to be intubated (a breathing tube needed to be inserted). On top of breathing problems, Rhys and Liam also had heart surgery to correct faulty heart valves and were operated on the same day.
Sadly, despite every effort brother Cullen passed away on January 16, 2007 and brother Daniel two days later.
“The care that we received at the NICU was beyond excellent. The nurses and the doctors were so caring and attentive and helped us through the roller coaster that all NICU parents ride. We will forever be grateful to them for the love and the care that they gave to all of our babies.”
– Nora Shipton
A Bittersweet Return Home
Liam spent 88 days and Rhys 98 days in the NICU. It was bittersweet for Nora and Rob when Liam and Rhys finally came home.
Three months after losing two of their sons, Nora and Rob White decided that they wanted to give back; to help support the NICU team who had helped Liam and Rhys survive their early entry into the world. Initially, they were inspired to contribute towards a twin water bed that was needed. The boys were in individual water beds but co-sleeping was proven to help healing. They realized, however that the water bed was a one-time gift and preferred something that would continue to give over time, as a need would arise. Nora’s late father, Ralph Shipton, researched Legacy Endowment Funds, it was just the thing they were looking for. The family then created the Cullen James and Daniel Morgan White Legacy Endowment Fund, which would contribute over the long term to meet the endless needs of the NICU.
Rhys and Liams’ first ChristmasThe boys celebrate their first birthday
The NICU graduates today
Liam and Rhys on the first day of Grade 7.
At 13, the boys are active and busy. They enjoy downhill skiing, swimming and camping. Their grandparents own a farm, so they like to go out on their ATVs, drive the tractors and fish. Rhys is a voracious reader and loves swimming. Liam also enjoys swimming and does horseback riding. Like many children, they struggle in math a little bit. They are happy, healthy boys.
Running for a Reason
In May 2020, Liam and Rhys are doing something extraordinary for The Ottawa Hospital NICU. They are running 5kms as a family-team in the Ottawa Race Weekend. On top of doing something fun and healthy, they are running to raise money for the NICU and running for their two brothers Cullen and Daniel, in the hope of keeping future families like theirs together.
Money that is raised through the Cullen James and Daniel Morgan White Legacy Endowment Fund (aka Preemies 4 Preemies), gets put towards things that the babies need. It may go towards helping purchase a large item like an incubator or a waterbed, which helps maintain a baby’s body temperature when they come out of the incubator, or smaller items like waterless milk bottle warmers, positioning aids, cell phone sterilizers or kangaroo care chairs. The endowment fund was set up in memory of Cullen and Daniel and it will continue to help other families who will need the latest, most innovative care for their preemies. Thanks to the forward thinking of their grandfather, their brothers’ Legacy Endowment Fund can keep on giving into the future.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Donors, NICU
A parent’s worst nightmare
14-year-old Spencer’s eye became reddish and tearing for more than a week; and this strange blockage was protruding from his nose. Despite repeated efforts, it would not come out.
That’s when Spencer’s mom, Ellen, knew he needed help and they would ultimately end up in CHEO’s emergency department. Doctors ordered a CT scan. It was around midnight; Ellen recalls when the results came in.
“A gravely concerned looking doctor asked me, ‘Did you know that Spencer has a tumour in his head?’”
It was not the news any parent wants to hear.
The growth, which was protruding from Spencer’s nose, was biopsied. While benign, that tumour was resulting in the quick deterioration of Spencer’s health. When Ellen asked to see the CT scan, she recalls searching the picture for a grape or golf ball sized image attached to a nose growth.
“I didn’t see any and asked where it was. ‘It’s the grey area’, the doctor said.”
The grey area was over half of his face.
“I didn’t even want to think about what his face would end up looking like after all the cutting they’d have to do to remove so much material, but I had to ask.”
The doctor revealed the tumour was larger than any he had ever worked with. It was for that reason and the fact it was reaching up to the floor of the brain, he told Spencer’s parents they couldn’t perform the surgery.
This type of tumour would need a specialized team of an ear, nose and throat doctor along with a neurosurgeon working together. Ellen recalls thinking she would take her son anywhere in the country to get the help he needed.
Specialized care at The Ottawa Hospital
However, the specialized care was nearby at The Ottawa Hospital. A highly skilled team would perform minimally invasive surgery and remove the tumour through Spencer’s nose.
Just over a week later, with his condition worsening, Spencer was to be admitted to The Ottawa Hospital. He had another CT, an MRI, and the specialized team was monitoring his optic nerve behind his bulging eye to ensure it wasn’t being severed by the growing tumour.
Two days later Spencer underwent a 4-hour surgery, which helped stop 80% of the blood flow feeding the tumour. The remaining 20% would maintain blood flow to his brain.
The next day the highly skilled team, which included Drs. Fahad Alkherayf and Shaun Kilty performed an eight-hour surgery. With expert precision, and state-of-the-art technology, they would remove the large tumour from Spencer’s face and base layer of the brain. They also rebuilt that layer to prevent the fluids that protect the brain from leaking out.
This minimally invasive surgery, removing the tumour and rebuilding the layer, was performed through Spencer’s nose by Dr. Alkherayf who has the greatest number of surgical hours of training for this procedure in Canada.
Dr. Fahad Alkherayf
Dr. Shaun Kilty
A Canadian Medical First
In order to rebuild the brain layer, 3D printing technology also aided doctors during the surgery. Ellen says it’s remarkable. “It’s really pretty cool the advancements which have been made to help patients in our community.” In 2016, The Ottawa Hospital became the first hospital in Canada to have an integrated medical 3D printer.
Ellen says her initial concerns of recovery completely faded thanks to this minimally invasive technique. “It was incredible. Spencer was home again only three days after surgery!”
When she thinks back to the fear of the initial diagnosis to where Spencer is today, back at school and active, several thoughts comes to mind.
“I was immensely grateful to God and The Ottawa Hospital, and I truly feel that we were in the best hands.”
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
Categories: Neuro, Technology
Story by Vesna Zic-Côté
“In 2012, I was diagnosed with early stage breast cancer. Despite the standard treatment of surgery, chemotherapy, radiation and hormonal treatment, the cancer returned four years later, having spread to my lungs, bones and lymph nodes.
I received my diagnosis of incurable stage 4 metastatic breast cancer on my son’s birthday. He was nine.
My world as I knew it ended. I was sitting upstairs on my bed. I could hear the kids playing downstairs. I called my husband at work and he came home and we cried.
It is a tradition in our home that on our kids’ birthdays, we go out to a restaurant of their choosing for dinner. So on the day my world ended, I sat in a restaurant and ordered some food and tried to eat cardboard, but couldn’t get the food to go down. I looked at the birthday boy and held the tears in, and my heart shattered in a million pieces.
Metastatic breast cancer is treatable, but not curable. When I was first diagnosed, my life expectancy was being measured in months. Now with cautious hope, it might be a few years. I go to the Hospital every 28 days to get injections. They are part of a series of targeted treatments I receive to keep the cancer cells at bay. One day, the cancer will figure out how to grow despite this treatment, and I will move onto something else. And I’ll continue this endless cycle of treatments and scans and progression and change until I am out of options. But I am a 43-year-old mother. And wife. And daughter. And sister. I need more time. Time to see my young children through elementary school. Time to watch my family grow and share in all the joys that life brings. Time to celebrate anniversaries with my husband and birthdays with my niece and nephews. Time with my beloved family and friends.
There is so much that needs to happen to make this a reality for me. I will need new treatments when my current regimen stops working – because it will stop working. I need research in cancer therapies and a health-care system that is streamlined and accessible.
Sadly, early detection does not prevent all cancers from returning and spreading. We need research to understand why, and treatment to extend our lives.
When I was first diagnosed, my focus was limited, directed inwards, focused on those dearest to me. During that time of learning about this new world, I absorbed every detail I could about metastatic breast cancer; living with metastatic breast cancer, treating metastatic breast cancer, dying metastatic breast cancer. A few names came to the forefront; those making noise, shifting opinions, moving the dial on research and progress. Months into treatment, when I could finally breathe again, I knew that I wanted to be part of this movement, part of the noise, part of the shift. I needed to validate this situation that I didn’t ask for in order to accept that it was part of my story whether I liked it or not.
For now, I have energy to cast outward. Not every day, but some days. Writing, fundraising, speaking, meeting. And I would say that the way I live my life has influenced my children who actively participate in my fundraising efforts with enthusiasm. They don’t need to feel embarrassed that their mom has cancer. Instead, they can feel like they are doing something to help me by climbing trees and selling apples, doing presentations on their fundraising efforts, wearing pink laces, and making signs, helping the doctors and researchers to find better medicines. Regardless of where we eventually land, I want them to be able to look back on all the good things that they did, and know that their efforts warmed many, many hearts… mine most of all.
On behalf of all of us living with incurable cancer – finding joy between injections and scans and blood work and appointments, living with hope and making a difference – thank you for your support.”
– Vesna
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
April 6, 2019, OTTAWA, ON – A sold-out crowd was brought to their feet when Dr. Natasha Kekre and Dr. Arleigh McCurdy were announced the winners of The Ottawa Hospital’s Dancing with the Docs Gala, presented by MD Financial Management, on Saturday night. Nine physicians and researchers partnered with a dance professional from Arthur Murray Dance Studio to compete for the Medicine Ball trophy. Scores from a panel of four judges were combined with the votes given for each contestant’s fundraising efforts.
This annual fundraiser raised $455,156 supporting innovative patient care and world-class research at The Ottawa Hospital. Tim Kluke, president of The Ottawa Hospital Foundation, said it was a thrilling night. “This truly is the most entertaining fundraiser I’ve seen in our city. Where else could you have nine, active, working doctors take to the stage and put on a show? It’s a big party and the whole room gets involved. It’s really a night like no other in our region. Thanks to the incredible success of Dancing with the Docs, funds will be supporting ground-breaking cancer research, our orthopaedic department, the SIM Centre, women’s health initiatives and so much more.”
“Thanks to the incredible success of Dancing with the Docs, funds will be supporting ground-breaking cancer research, our orthopaedic department, the SIM Centre, women’s health initiatives and so much more.”
Tim Kluke, President and CEO of The Ottawa Hospital Foundation
The fancy footwork of the nine competitors from The Ottawa Hospital was contagious. After the official ceremony was over, guests hit the dance floor at the Hilton Lac-Leamy to show off their own dance moves, potentially vying for a spot to compete next year.
The Ottawa Hospital is one of Canada’s largest learning and research hospitals, with more than 1,200 beds, over 12,000 staff members and an annual budget of approximately $1.2 billion.
Our focus on learning and research helps us develop new and innovative ways to treat patients and improve care. As a multi-campus hospital affiliated with the University of Ottawa, we deliver specialized care to the Eastern Ontario region, but our techniques and research discoveries are adopted around the world. We engage the community at all levels to support our vision for better patient care.
From the compassion of our people, to the relentless pursuit of new discoveries, The Ottawa Hospital never stops seeking solutions to the most complex health care challenges.
For more information about The Ottawa Hospital, visit ohfoundation.ca.
A bystander only sees neurosurgeon Dr. Adam Sachs wearing large goggles, looking at the air between the two wands he moves back and forth in front of him. What Dr. Sachs sees is a three-dimensional image of a patient’s brain, with its electrical activity superimposed. This isn’t a video game. It’s the cutting-edge of deep brain stimulation and neurosurgery technology.
Wearing virtual reality goggles, Dr. Sachs can view an accurate, computer-generated 3D image of a patient’s brain with Parkinson’s disease, created using the patient’s own MRIs. The patients’ brain activity recorded from microelectrodes can be visualized in this virtual world. With the two wands, or joysticks, he can move the three-dimensional brain around, seeing it from all angles. He can also remove layers of the brain to look inside at the exact spot where he will place a DBS electrode during deep brain stimulation (DBS) surgery. He is hoping to soon use this technology in the operating room.
Neurosurgeon Dr. Adam Sachs is planning to use 3D virtual reality in his deep brain surgery for patients with Parkinson’s.
This medical 3D virtual reality system was developed at The Ottawa Hospital, and is expected to be the first of its kind in the world to be used for deep brain stimulation surgery. Drs. Justin Sutherland and Daniel La Russa are clinical medical physicists in the hospital’s radiation oncology department. The two used their imaging expertise to develop a virtual reality system that combines a patient’s MRIs and CT scans to create a 3D image of a patient’s organ or body part to give surgeons a detailed, accurate representation of the surgical area.
Historically, medical virtual reality programs were used by patients mainly for rehabilitation. Patients would wear VR-goggles to help relearn how to move through and cope with different environments. Until recently, the technology wasn’t good enough to create images of organs or tissue that could be used by clinicians in a manner that improves on current practice.
“What we are trying to do in our virtual reality lab is come up with new ways to leverage technology to help doctors and nurses, or any medical professional, do what they do better. And how better than with 3D visualization,” said Dr. Sutherland who is also an assistant professor in the University of Ottawa’s Department of Radiology. “We think the technology has only reached that point now. We’re now at a place where we want to pursue the avenue of clinicians-as-users.”
“Nowhere else in the world are they using virtual reality in this fashion.”
— Dr. Adam Sachs
One Ottawa Hospital surgeon interested in using 3D virtual reality was Dr. Sachs, who performs deep brain stimulation surgery for people with Parkinson’s. During this procedure, a microelectrode, no wider than a human hair, is implanted into a very specific area of the brain. The microelectrode then records activity from and stimulates that part of the brain and alleviates some of the patient’s symptoms, such as tremors and akinesia or the loss of ability to move their muscles voluntarily. The virtual reality system allows the electrical activity, stimulation effects and the MRI to be visualized together.
“In deep brain stimulation surgery, because the target is very small and in the middle of the brain this leaves the surgeon with the problem of how to visualize the person’s brain to understand the area and where to put the electrode,” said Dr. Sachs.
Neurosurgeon Dr. Adam Sachs uses virtual reality wands to manipulate a 3D image of the brain.
He said neurosurgeons use MRIs and brain atlases to get a mental image of what the patient’s brain looks like. The problem is these atlases are maps created from many different people’s brains, but each patient’s brain is unique. As well, the brain atlases are only two-dimensional, while the brain is three-dimensional. This makes it difficult to place the microelectrode in the exact spot in the patient’s brain where it will have the best chance of halting or reducing the Parkinson’s tremors.
Dr. Chadwick Boulay, a senior research associate in the neuroscience program, understands the challenges faced by neurosurgeons when implanting an electrode at the optimal position in the brain. When Dr. Boulay learned about the 3D virtual reality technology being developed at The Ottawa Hospital, he realized the potential this had for increasing the accuracy of deep brain stimulation surgery. He and Dr. Sachs worked with Drs. Sutherland and La Russa to develop a virtual reality program that would enable them to see the patient’s brain in three dimensions.
“This is really exciting,” said Dr. Sachs. “The deep brain stimulation electrodes will be more precisely placed because we’ll be able to integrate accurate images from the patient’s anatomy and visualize it in three dimensions,” said Dr. Sachs.
He anticipates that the resulting precision of the placement of the electrode will improve outcomes for patients with Parkinson’s disease, but this will be confirmed through research. About 15 people undergo deep brain stimulation surgery at The Ottawa Hospital every year.
“We’re excited about working with the Sachs Lab because it is a perfect clinical example of using 3D visualization to better understand a spatial problem,” said Dr. Sutherland. “In this case, actually seeing a target for deep brain stimulation removes the burden on the surgeons of trying to create a 3D model in their head.”
Drs. Daniel LaRussa, Justin Sutherland, and Chadwick Boulay have teamed up to design a 3D virtual reality program for Dr. Adam Sachs’ deep brain stimulation surgery.
Dr. Sutherland foresees that this 3D virtual reality technology will one day be in every department throughout the hospital. He says the overall system is surprisingly inexpensive, as the computer that runs it and the goggles only cost a few thousand dollars. The possibilities for this technology are endless. He said it has huge potential for education—teaching medical anatomy—and for surgical planning. Dr. Sutherland sees Dr. Sachs’ endorsement of this system as a shining example of how doctors can use this technology to improve what they do.
“Nowhere else in the world are they using virtual reality in this fashion,” said Dr. Sachs.
The Ottawa Hospital is quickly being positioned as leaders in 3D virtual reality technology and has already gained international attention. Drs. Sutherland and La Russa have given demonstrations and been invited to talk at large medical conferences, and other institutions have contacted them with interest in using this technology.
The Ottawa Hospital is a leading academic health, research, and learning hospital proudly affiliated with the University of Ottawa.
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“In 2012, I was diagnosed with early stage breast cancer. Despite the standard treatment of surgery, chemotherapy, radiation and hormonal treatment, the cancer returned four years later, having spread to my lungs, bones and lymph nodes.
