SPECIAL EDITION: MEDICAL MARVELS

Encore: December 13, 2021

We will take you inside the operating room at New York’s Mount Sinai Hospital, where brain surgeons are using cutting-edge technology to treat patients more effectively.

Aired on June 25, August 8, December 17, 2019 & February 26, 2020.

TRANSCRIPT

TONIGHT ON METRO FOCUS, A SPECIAL EDITION, SCI-FI TAKES OVER THE OR.

FROM 3-D IMAGING TO AUGMENTED REALITY, OUR NEW MEDICAL MARVEL SERIES KICKS OFF INSIDE THE OPERATING ROOM AT NEW YORK'S MOUNT SINAI HOSPITAL WHERE BRAIN SURGEONS ARE USING TECHNOLOGY TO TREAT PATIENTS MORE EFFECTIVELY.

IN A MOMENT THE DOCTORS USING THESE TREATMENTS GIVE US A REVIEW OF THE BRAIN.

PLUS, WE'LL TAKE YOU INSIDE A PROCEDURE THAT'S HELPING PARKINSON'S PATIENTS REDUCE TREMORS.

THOSE STORIES AND MORE AS THIS SPECIAL EDITION OF 'METROFOCUS' MEDICAL MARVELS STARTS RIGHT NOW.

THIS IS 'METROFOCUS' WITH RAFAEL PI ROMAN, JACK FORD, AND JENNA FLANAGAN.

'METROFOCUS' IS MADE POSSIBLE BY JAMES AND MERRYL TISCH, SUE AND EDGAR WACHENHEIM III, THE SYLVIA A. AND SIMON B. POYTA PROGRAMING ENDOWMENT TO FIGHT ANTI-SEMITISM.

BERNARD AND IRENE SCHWARTZ, ROSALIND P. WALTER, BARBARA HOPE ZUCKERBERG, AND BY -- GOOD EVENING AND WELCOME TO THIS SPECIAL EDITION OF METRO FOCUS.

I'M JACK FORD.

THIS IS THE FIRST IN OUR NEW SERIES OF REPORTS EXAMINING ADVANCES IN THE MEDICAL FIELD MAKING ONCE THE STUFF OF STAR TREK REALITIES IN THE WORLD.

HOSPIT HOS ONE PLACE HIGH CHECK CHANGES HAVE AN IMPACT THE OPERATING ROOM.

AUGMENTED AND VIRTUAL REALITY, 3-D IMAGING AND GAMMA RADIATION HAVE EMERGED TO BECOME TODAY'S CUTTING EDGE TOOLS OF THE TRADE.

JOINING ME WITH INSIGHT INTO ALL OF THESE MEDICAL MARVELS HAPPENINGING ARE IN YOUR ROW SURGEON DR. JOSHUA BEDERSON AND CLINICAL DIRECTOR LESLIE SLAKTER.

WE WANT TO THANK YOU BOTH FOR JOINING US HERE.

THIS IS -- IT'S FASCINATING WHAT YOU ARE ALL DOING NOW.

AND I SPENT THE NIGHT LAST NIGHT LOOKING AT SOME OF THESE VIDEOS AND MARVELING AT THE PROGRESS BEING MADE.

TO SET THE STAGE FOR SOME OF THIS, AND DOCTOR, LET ME ASK YOU THIS FIRST, GIVE US A SENSE IN THE YEARS THAT YOU HAVE BEEN PRACTICING NEUROSURGERY, GENERALLY SPEAKING, HOW SIG ANYWHERE CAN'T HAVE BEEN THE CHANGES, THE DEVELOPMENTS IN YOUR FIELD OF MEDICINE?

IT'S BEEN ENORMOUS CHANGES.

THE TECHNOLOGY HAS MADE SAFER THE SURGERIES.

IT HAS GIVEN US A SENSE OF ORIENTATION TO GIVE YOU SOME SORT OF ANALOGY, WE DIDN'T HAVE GPS IN OUR CARS WHEN I STARTED OPERATING.

AND WE DIDN'T HAVE GPS FOR THE BRAIN.

AND NOW WE DO.

SO IN THE SAME WAY THAT YOU COULD LOOK AT A SCREEN IN YOUR CAR AND KNOW WHERE YOUR CAR IS RELATIVE TO THE MAP OF MANHATTAN, YOU CAN SEE YOUR INSTRUMENTS IN RELATION TO THE MAP OF THE BRAIN AND KNOW EXACTLY WHERE YOU ARE.

YOU CAN SEE AROUND CORNERS AND SEE THROUGH TISSUES.

SO THERE HAVE BEEN ENORMOUS ADVANCES.

SO WITH THAT AS A SETUP, I WANT TO TAKE A LOOK, I WANT OUR FOLKS TO TAKE A LOOK AT A PIECE THAT WE HAVE THAT BOTH OF YOU WERE INVOLVED IN, AS A MATTER OF FACT.

SO METRO FOCUS'S MADDIE ORTON VISITS BOTH IN THE OPERATING TO TAKE A LOOK AT THIS TECHNOLOGY, THESE NEW TOOLS FIRSTHAND.

LET'S TAKE A LOOK.

LISA GALIO TA OF LONG ISLAND, NEW YORK, WAS EXPERIENCING PAIN IN HER NECK WHEN SHE GOT AN MRI IN MARCH OF 2018.

IT REVEALED AN UNVEALED AND SHOCKING DISCOVERY.

SHE HAD FIVE BENIGN TUMORS IN HER BRAIN, ONE REACHED THE SIZE OF AN ORANGE.

MAKING MATTERS OF THE WORSE IT, HAD ARTERIES WRAPPED AROUND IT.

REMOVING A BRAIN TUMOR IS A CHALLENGING PROCEDURE BUT DR. JOSHUA BEDERSON AT THE MOUNT SINAI HOSPITAL IN THE NEW YORK CITY HAS HI-TECH TOOLS TO HELP NAVIGATE THE TRICKY SURGERY RIDS.

HE'S ONE OF THE FIRST BRAIN SURGEONS IN THE COUNTRY TO USE 3-D IMAGES OF THE BRAIN INTEGRATED WITH AUGMENTED AND VIRTUAL REALITY.

AUGMENTED AND VIRTUAL REALITY HELP US MANAGE A SITUATION LIKE THIS IN MANY WAYS FROM THE INITIAL PATIENT CONSULTATION ALL THE WAY THROUGH THE PLANNING OF THE CASE AND GENERALLY NAVIGATING TOWARDS SAFE CORRIDORS OF SURGERY.

HERE'S HOW IT WORKS.

2DMRI AND CT SCANS REFERRED TO AS DIE COME I THINKS ARE DIGITALLY FUSED 0 TOGETHER TO CREATE A 3-D IMAGE OF THE PATIENT'S BRAIN.

SOFTWARE IS THEN USED TO PAINT OUTLINES OF THE TUMORS, ARTERIES AND VEINS DIFFERENT COLORS ON THAT IMAGE.

THIS CREATES A COMPREHENSIVE MAP OF TARGETS AND NO-FLY ZONES FOR THE PROCEDURE AHEAD.

HOLLY EMKE RESERVES NEW TECHNOLOGY IN THE SURGERY PROCESS AND HELPS DR. BEDERSON IMPLEMENT AND OPTIMIZE THESE TOOLS.

WE HAVE TELL THE COMPUTER WHAT PIECES OF THE ANATOMY WE'RE INTERESTED IN.

SO WE'RE USING A TOOL CALLED SMART BRUSH TO ACTUALLY PAINT ON THE DIE COME IMAGES THE TUMOR AS A WHOLE.

ALL THOSE IN THERE, THOSE HAVE TO GO.

WE'VE OUTLINED THE SINUS WHICH IS A MAJOR VEIN IN THE BRAIN AND THE ARTERIES THAT ARE EITHER FEEDING THE TUMOR OR CLOSE TO THE TUMOR THAT HAVE POTENTIAL TO CAUSE DAMAGE IF WEERN TO DISRUPT THEM IN SOME WAY.

INFERIOR SAGITTAL SINUS.

MAYBE ORANGE IS A GOOD COLOR.

FOR LISA'S SURGERY THIS COLOR CODED 3-D MAP HELPS DR. BEAD BEDERSON AND HIS TEAM DEVELOP THEIR PLAN.

BY PLANNING THIS CASE WE'RE ABLE TO VISUALIZE AHEAD OF TIME WHAT THE TUP MORE LOOKS LIKE BEFORE EVEN GETTING INTO THE OPERATING ROOM.

THE PATIENT GALIO TA IS THE ALSO ABLE TO VISUALIZE WHAT THE TUMORS LOOK LIKE AND HOW DR. BEDERSON PLANS TO ADDRESS THEM.

A BIG BENEFIT FOR LAY PEOPLE ABOUT TO UNDERGO MAJOR SURGERY.

IT'S ONE THING TO BE TOLD BY A SURGEON YOU HAVE A TUMOR AND WE HAVE TO MAKE AN INDECCISION R THE TOP OF YOUR HEAD.

IT'S ANOTHER TO SEE YOUR OWN TUMOR IN THREE DIMENSIONS IN RELATION TO YOUR OWN FACIAL FEATURES AND TO UNDERSTAND EXACTLY WHY WE WOULD BE MAKING AN INCISION HERE AND WHERE WE WOULD BE DOING THE OPENING.

> ALTHOUGH THIS IS STILL AN INVASIVE SURGERY, IT SEEMS A LITTLE LESS INVASIVE TO ME THAT HE KIND OF KNOWS WHERE HE'S GOING.

SHE GETS ROLLED INTO THE OPERATING ROOM.

IT'S IN HERE THE TECHNOLOGY PERHAPS COMES MOST IN HANDY.

THE 3-D COLOR CODE LINES CREATED TO OUTLINE HER TUMORS, VEINS AND ARTERIES ARE AVAILABLE TO DR. BEDERSON IN THE OPERATING ROOM THROUGH AUGMENTED REALITY.

HE CAN VIEW THE ANATOMY WITH THE NAKED EYE AND THEN LOOK THROUGH A MICROSCOPE THAT PROVIDES AN OUT-LIONEL OVER THE OUT LINE SO HE CAN SEE WHERE THE ARTERIES AND VEINS LIE BEFORE HE REACHES THEM, A HEADS UPDISPLAY.

PILOTS USE THE INFORMATION BY LOOKING AHEAD AND FLYING RATHER THAN LOOKING DOWN AT THEIR INSTRUMENTS.

PRIOR TO HEADS-UP DISPLAY CAPABILITY, A SURGEON'S METHODS WOULD HAVE BEEN VERY DIFFERENT.

YOU WOULD HAVE USED A MAP, LOOKS AT THE CT SCAN, GONE BACK TO THE PATIENT, LOOKED AT THE PATIENT INTERNALIZING WHAT YOU'VE SEEN ON THE SCAN AND TRYING TO PROJECT THAT ONTO THE PATIENT IN THE AN ACCURATE WAY.

MORE RECENTLY, DR. BEATER SON RELIED ON A GPS-LIKE NAVIGATION PROBE.

THE TIP OF WHAT LOOKS LIKE A PEN TOUCHES THE PATIENT'S ANATOMY AND SINKED WITH A MATCH THE BRAIN TO TELL THE SURGEON WHERE IS HE IN REALTIME.

THIS IS WHAT MOST SURGEONS CURRENTLY USE.

HE ALSO INCORPORATES THIS NAVIGATION PROBE INTO HIS PROCESS BUT DOESN'T HAVE TO RELY ON IT SOLELY ANYMORE.

THAT'S A BIG ADVANCE BUT STILL REQUIRES THAT YOU STOP WHAT YOU'RE DOING, LOOK AT THE MAP, AND THEN GO BACK TO WHAT YOU WERE DOING.

IN THE ANALOGY OF FLYING A PLANE, YOU HAVE TO STOP FLYING THE PLANE TO LOOK AT YOUR INFORMATION AND THEN START FLYING THE PLANE AGAIN.

THAT'S NO LONGER AN ISSUE.

DR. BEDERSON SAYS HEADS UP DISPLAY TECHNOLOGY FOR SURGERY MADE HIS WORK FASTER AND SAFER.

TO USE THE HEADS-UP DISPLAY PROJECTION OF THE VIRTUAL REALITY RECONSTRUCTION ONTO THE SCALP WHILE WE'RE PLANNING THE SKIN INCISION SO THAT WE CAN POSITION THE OPENING PRECISELY AND GIVE US THE MAXIMUM EXPOSURE FOR THE MINIMUM OPENING, LIKEWISE AFTER THE SKIN INCISION WE'LL BE ABLE TO BE POSITION OUR CRANIOTOMY WHICH IS THE OWN OPENING OVER THE TUMOR BY PROJECTING THE TUMOR ONTO THE SURFACE OF THE SKULL AND SEEING THROUGH THE SKULL TO THE TUMOR TO MORE PRECISELY OUTLINE THE OPENING.

IT HELPS THE REST OF THE TEAM SEE WHAT DR. BEDERSON SEES IS, AS WELL BECAUSE THE MICROSCOPE HE USES ALSO FUNCTIONS AS AN EXOSCOPE PROVIDING A MAGNIFIED VIDEO FEED TO A SCREEN CLETE K COMPLETE WITH THE COLOR CODED OUTLINES VIEWED IN 2D OR 3-D WITH GLASSES.

THE TEAM CAN SEE THE CLEAR SOLID OUTLINES OF THE PATIENT'S TUMORS AND VEINS AND ARTERIES DESPITE FLOWING IN THE TUMOR AND ANTICIPATE WHERE THE STRUCTURES ARE AS THEY MOVE FURTHER INTO THE BRAIN THANKS TO DOTTED OUTLINES THAT PROVIDE DEPTH PERCEPTION SIX HOURS LATER, THE SURGERY IS A SUCCESS.

CAN YOU STAND ON ONE FOOT?

EXCELLENT.

THEN THE OTHER FOOT.

GOOD.

TODAY IS MY FOLLOW-UP VISIT DR. BEDERSON.

I HAD BRAIN SURGERY TWO WEEKS AGO.

AND I'M FEELING AWESOME.

AND YOU NEVER HAD ANY SEIZURES.

I THINK THAT DRIVING IS OKAY FOR YOU NOW.

GREAT.

GET MY INDEPENDENCE BACK.

I THINK THE TECHNOLOGY MADE A BIG DIFFERENCE.

IT HELPED US IDENTIFY THE IMPORTANT VASCULAR STRUCTURES THAT HAD BEEN DISPLACED AND ENVELOPED BY THE TUMOR AND WERE AT CONSIDERABLE RISK WHEN WE REACHED THE DEEP PARTS OF THE TUMOR REMOVAL.

SO KNOWING EXACTLY WHERE THOSE WERE, BEING ABLE TO NAVIGATE TO THEM AND THEN TO STAY AWAY FROM THEM ONCE WE WERE NEARBY WAS KEY IN PREVENTING A STROKE.

DR. BEDERSON IS ALREADY EXCITED ABOUT NEW TECHNOLOGICAL FEATURES UNDER DEVELOPMENT WITH SELF OF THE HOSPITAL'S PARTNERS.

WHAT IF WE COULD ALSO PROVIDE HAPTIC FEEDBACK TO MY INSTRUMENTS?

WE COULD PROVIDE AUDITORY INFORMATION, ASSIGN DIFFERENT TISSUES DIFFERENT SOUNDS, FOR EXAMPLE.

WITH EACH TECHNOLOGICAL ADVANCE, THE HOPE IS FOR MORE AMOUR OUTCOMES CAN LIKE LISA GALIOTO'S.

SHE'S AS NORMAL AS CAN BE.

YOU CAN'T MAKE SOMEONE BETTER THAN NORMAL I DON'T THINK.

THIS IS NOT A MEDICAL TERM BUT I THINK I'M SAFE IN CHARACTERIZING THESE AS BREATHTAKING ADVANCES IN TECHNOLOGY.

I'VE GOT A COUPLE QUESTIONS FOR BOTH OF YOU AND WANT TO GET INTO THE SPECIFIC KAYS.

LESLIE, TALK ABOUT HOW THIS AIDS IN DEALING WITH PATIENTS AND HELPING THEM UNDERSTAND THEIR CIRCUMSTANCES AND AND PERHAPS MORE IMPORTANT WHAT IT IS THAT'S GOING TO TAKE PLACE IN THE OPERATING ROOM.

MY GOAL AS A PHYSICIAN ASSISTANT IS TO HELP THE PATIENT THROUGH THE PERIOPERATIVE PERIOD, EVERYTHING THAT HAPPENS BEFORE AND AFTER THE SURGERY AND HELP THE DOCTOR AS NEEDED DURING THE SURGERY AND MAKING SURE THE PATIENTS ARE COMFORTABLE AND AGREEABLE TO WHAT'S ABOUT TO HAPPEN TO THEM.

YOU FIND OUT R YOU HAVE A TUMOR AND YOU HAVE TO SEE A IN YOUR ROW SURGEON AND MEETING SOMEONE TALKING ABOUT YOUR BRAIN.

YOU'RE LOOKING AT INS THAT ARE BLACK AND WHITE AND GRAY.

WE TURN THAT INTO COLORFUL PICTURES THAT THEY CAN INTERACT WITH.

IT OPENS UP A DOOR TO A CONVERSATION ABOUT EXACTLY WHERE WE'RE GOING TO SHAVE THEIR SKIN, WHERE WE'RE GOING TO CUT THE SKIN, OPEN UP THE BONE AND WHAT OUR APPROACH IN REPAIR IS GOING TO BE.

BECAUSE THEY CAN TOUCH IT AND FEEL IT AND PLAY WITH IT AND HAVE TIME WITH MYSELF AND MY TEAM, NO QUESTIONS GO YOU BE ANSWERED.

AND EVEN IF THERE ARE POTENTIAL SIDE EFFECTS OR COMPLICATIONS THEY WERE ABLE TO VISUALIZE WHAT THAT IS IN COLOR OF THEIR OWN BRAIN.

IT REALLY IS COMPLETELY CHANGING THE WAY WE INTERACT WITH PATIENTS.

I'VE HAD 13, 14 ORTHOPEDIC SURGERIES OVER THE YEARS.

THE UNCERTAINTY IS ALWAYS TROUBLING.

EXACTLY WHAT ARE YOU GOING TO DO?

WHAT IS IT GOING TO LOOK LIKE BEFORE AND AFTER?

MY GUESS IS HELPS THEM, IT'S GOING TO BE ANXIETY RIDDEN, BUT TAKE AWAY SOME OF THE UNCERTAINTY.

RIGHT AND BUILDS CONFIDENCE.

MOUNT SINAI IS A GREAT TEACHING INSTITUTION.

SO OF YOUR FOCUS IS TEACHING PEOPLE IN THE MEDICAL FIELD.

HOW DOES THIS HELP YOU IN TEACHING PEOPLE WHO ARE GOING TO BECOME IN YOUR ROW SURGEONS?

IT'S PRETTY HELPFUL.

THE RESIDENCY IS SEVEN YEARS ALONG.

THEY GET A LONG EXPOSURE TO IT AND TAKE ON GRADUATED RESPONSIBILITY AS THEY BECOME MORE SKILLED.

BUT TRANSLATING WHAT WE TALK ABOUT IN A CONFERENCE TO THE OPRYING ROOM, FOR EXAMPLE, POSITIONING THE PATIENT YOUR VERY FIRST TIME, WHAT'S THE EXACT RIGHT ANGLE OF THE HEAD TO MAXIMIZE OUR EXPOSURE AND MAKE IT EASY ON THE SURGEON AND PATIENT.

THAT'S A BIG STEP FROM LOOKING AT A SCAN AND TRANSLATING THATTING INTO THREE DIMENSIONAL SPACE INTO A PATIENT POSITION.

NOW, WITH THE TECHNOLOGY THEY CAN CHECK WHAT THEY'VE DONE BEFORE WE GET IN THERE BY LOOKING AT THE HEADS-UP DISPLAY AND THE VIRTUAL REALITY AND THEY WILL ADJUST THE POSITION BEFORE I EVEN COME INTO THE ROOM SO IT'S OPTIMIZED.

LIKEWISE, WHERE DO YOU SHAVE THE SCALP?

THAT'S A VERY IMPORTANT ISSUE FOR THE PATIENT.

SURE.

AND THE RESIDENT --

YOU'RE NOT TAKING ALL THE HAIR OFF.

NOT ANYMORE.

WE USED TO.

YOU WANT TO BE MORE PRECISE.

THAT'S RIGHT.

LET ME ASK YOU THIS, TAKE US THROUGH.

WE'VE GOT A COUPLE OF VIDEOS, ABOUT 30 SECONDS EACH, NO AUDIO ON DIFFERENT SURGICAL PROCEDURES.

I WANT TO ASK YOU TO NARRATE THEM FOR US.

IT WILL SHOW THE INTRODUCTION OF HIGH TECHNOLOGY.

THE FIRST ONE HAS TO DO WITH A BRAINSTEM TUMOR.

WHAT DOES THAT MEAN AND WHAT ARE YOU HOPING TO DO IN THIS PROCEDURE?

IN THIS CASE IT'S A VERY LARGE BRAINSTEM TUMOR IN A VERY HIGH FINGERSENING PERSON WHO STARTED BOUNCING AFTER THE WALLS.

SHE HAS FIVE KIDS AND SHE JUST THOUGHT THAT IT WAS TAKING A TOLL ON HER BUT IN FACT, SHE HAD A HUGE TUMOR CAUSING MAJOR COMPRESSION OF HER BRAINSTEM.

THAT'S WHAT WE'RE SEEING RIGHT NOW?

THAT'S THE YELLOW IS THE TUMOR.

AND WHEN SHE CAME IN, SHE MET LESLIE AND I AND WE SHOWED HER THIS AND I THINK BOTH SHE AND HER HUSBAND WERE PRETTY SHOCKED TO ME THE SIZE OF THIS TUMOR AND TO UNDERSTAND WHY SHE WAS HAVING THESE SYMPTOMS.

THERE'S A SECOND ONE I WANT YOU TO TALK ABOUT THAT HAS TO DO WITH APY DUERY TUMOR.

EXPLAIN WHAT WE'RE GOING TO BE SEEING HERE.

THIS PATIENT HAD A GIANT PITUITARY TUMOR LOCATED RIGHT IN THE CENTER OF THE HEAD PRESSING UPWARD ON THE OPTIC NERVES AND CAUSING BLINDNESS AND VISUAL LOSS.

WHAT WE FOUND OUT AFTERWARDS AND BEFORE THE SURGERY WAS THAT IN ADDITION TO THE PITUITARY TUMOR, HAD HE TWO ANEURYSMS WHICH ARE BUBBLES ON THE BLOOD VESSELS WHICH YOU CAN SEE HERE RIGHT NOW POINTING INWARD.

THESE ARE AT RISK OF RUPTURE AND CERTAINLY IF YOU TOUCH THEM DURING THE SURGERY, THEY'RE GOING TO RUIN YOUR DAY AND HIS.

AND SO IT WAS REALLY IMPORTANT TO BE ABLE TO NAVIGATE AND TO SEE THESE ANEURYSMS THROUGH THE TISSUE WHILE WE WERE DOING THE CASE TO STAY AWAY FROM THOSE.

I WANT TO SHOW OUR VIEWERS SOMETHING AND THEN I'LL TALK MORE HERE.

ANOTHER ADVANCEMENT THAT WE'RE SEEING A DESIGN CHANGE TO SMALLIE LEK ELECTRODES IMPLANTED IN THE BRAIN DURING DEEP BRAIN SIMULATIONITION SURGERY PRI.

THIS TINY TWEAK HAS A WORLD OF IMPACT.

ANNE WAS DIAGNOSED WITH PARKINSON'S DISEASE IN 1986.

12 YEARS LATE ARER, SHE BECAME ONE OF THE FIRST TO RECEIVE DEEP BRAIN STIMULATION OR DBS SURGERY TO TREAT HER DISEASE.

IT'S A PROCEDURE WHERE A DEVICE IMPLANTED IN THE UPPER CHEST SENDS ELECTRICAL IMPULSES INTO THE BRAIN THROUGH WIRES CALLED LEADS THAT ARE TIPPED WITH ELECTRODE CONTACTS.

THE NEUROSTIMULATION CALMS THE SYMPTOMS LIKE TREMORS BUT RECENTLY, HER 20-YEAR-OLD DEVICE STOPPED WORKING.

SO TWO DECADES AFTER HER FIRST DBS SURGERY, SHE'S SCHEDULED FOR ANOTHER ONE AT MOUNT SINAI HOSPITAL IN NEW YORK CITY.

DR. BRIAN COPPELL IS HER SURGEON.

THE LEAD FRAUD AND LIKE ANY MANMADE DEVICE, THIS CAN -- THESE LEADS CAN BREAK.

DBS IS A PACEMAKER FOR THE BRAIN.

IF IT BREAKS, ELECTRICITY CAN'T FLOWEN AN THEY LOSE EFFICACY.

THAT'S WHAT HAPPENED WITH ANNE.

GOING INTO HER SECOND OF TWO LEAD IMPLANT SURGERIES, SHE IS OPTIMISTIC.

SHE SAYS SHE KNOWS THE PROCEDURE WILL ALLOW HER TO GO BACK TO DOING ACTIVITIES WITHOUT TREMOR BECAUSE HER FIRST DEEP BRAIN STIMULATION SURGERY TWO DECADES AGO WORKED WONDERS.

IT WAS A MIRACLE.

PLAIN AND SIM, A MIRACLE.

I WAS SHAKING WHEN I WENT INTO THE OPERATING ROOM AND I WASN'T WHEN I CAME OUT.

NURSE PRACTITIONER JOAN WHO IS ALSO ASSISTING McCLOSKEY WITH THIS PROCESS SAYS IT'S NOT ENTIRELY KNOWN WHY NEUROSTIMULATION CALMS THE SYMPTOMS.

BUT IT'S USED IN A CASE LIKING THISSING IS CLEAR.

FOR SOMEONE HOB HAS SO MANY YEARS OF PARKINSON'S DISEASE, IT'S HARD FOR US TO COVER THOSE SYSTEMS WITH JUST MEDICATION ALONE SHE RESPONDS WELL TO MEDICATION BUT IT DOESN'T AS LONG, SO THE DEEP BRAIN SIMULATION HELPS US TO MANAGE THE FLUCTUATIONS SO THE OFF TIMES BECOME BETTER AND SO HER MEDICATION CAN REALLY LAST THROUGH THE DAY.

Reporter: THE NEW DBS SYSTEM WILL BE IMPLANTED IN BOTH SIDES OF HER BRAIN SO THE SURGERY IS DONE OVER TWO DAYS.

ONCE THE LEADS ARE IN AND SHE'S HAD TIME TO HEAL, McCLOSKEY WILL RETURN TO HAVE THE DEVICE CALIBRATED TO THE LEVEL OF STIMULATION SHE REQUIRES.

THIS PROCESS HAS BECOME MORE ACCURATE THANKS TO A RECENT ADVANCE IN THE FIELD.

THE PRODUCT THAT WE USE TODAY IS THE FIRST OF THE ADVANCES IN THE DBS LEAD DESIGN SINCE DBS WAS INTRODUCED IN.

THE UNITED STATES IN THE LATE '90s.

THE TRADITIONAL DBS LEAD HAD FOUR CONTACTS AND EACH FOUR CONTACTS LOOKED LIKE A LITTLE CYLINDER.

SO WHEN YOU SIMULATED YOU CREATED A FIELD THAT WAS SYMMETRIC AND OWL SIDES OF THE LEAD.

IF THE LEAD WERE SLIGHTLY TOO CLOSE TO SOME AREA THAT YOU DIDN'T WANT TO STIMULATE, YOU HAD TO SORT OF TRADE OFF BETWEEN EFFECTIVE STIMULATION AND SIDE FECTS.

HE SAYS SURGEONS LIKE HIM WANTED A LEAD THAT PROVIDESES A SYMMETRICAL STIMULATION ALLOWING DOCTORS TO STIMULATE IN ONE AREA BUT NOT AFFECT AT ADJACENT AREA.

THESE NEW LEADS PROVIDE THAT CAPABILITY.

IN THE OPRYING ROOM, HE ORIENTS THE LEAD TO TAKE ADVANTAGE OF THE NEW ELECTRODE LAYOUT.

PRIOR TO THE IMPLANT SURGERY, COPPELL DOES SEVERAL CHECKS OF BRAIN IMAGING TO MAKE SURE HE IDENTIFIES THE OPTIMAL IMPLANT LOCATIONINGS.

ALL RIGHT, ANNE, DO ME A FAVOR.

SHE IS AWAKE BUT SEDATED.

IN ADDITION TO FOLLOWING THE MAP PROVIDED THROUGH BRAIN IMAGING, HE LISTENS TO FREQUENCIES GIVEN OFF BY THE BRAIN'S NUKE KLEE WHY I WHERE THE LEAD IS STIMULATING WITHIN THE LEAD.

ONCE THE LEAD IS IN THE TARGETED LOCATION, HE TURNS ON THE ELECTRODES AND ASKS THE PATIENT TO FOLLOW COMMANDS.

HE CHECKS HER REACTIONS TO SEE WHETHER THE STIMULATION CAUSES CAN HER NORMAL TREMOR OR STIFFNESS TO SUBSIDE.

OPEN AND CLOSE YOUR HAND BIG AND WIDE.

HOW DOES THAT FEEL?

ONE MONTH LATER, McCLOSS SKI VISITS IS MOUNT SINAI FOR A FOLLOW-UP APPOINTMENT WHERE HER NEW DBS DEVICE IS PROGRAMMED BY THIS NURSE PRACTITIONER.

TODAY IS HER FIRST INITIAL PROGRAMMING VISIT.

WE'RE GOING TO BE TURNING ON HER ELECTRODES TODAY.

SHE'LL BE OFF MEDICINE AND WE'LL SEE WHAT THE STIMULATION DOES BY ITSELF AND THEN WE HAVE HER TAKE HER MEDS SO WE CAN SEE WHAT MEDICATION AND SIMULATION DOES AT THE SAME TIME.

FIVE, FOUR, THREE, TWO, ONE.

JUST A LITTLE TREMOR.

SHE USES SOFTWARE ON A SMART DEVICE THAT ALLOWS HER TO GO THROUGH EACH ELECTRICAL CONTACT IN THE BRAIN, SET THE AMPLITUDE AND TEST WHAT HAPPENS TO HER SYMPTOMS.

TYPICALLY WE CAN TREAT THE SYMPTOMS OF PARKINSON'S CALLED MOTOR SYMPTOMS.

WE CAN TREAT TREMOR, STIFFNESS HAD, MOVEMENT AND DYSKINESIAS WHICH ARE EXTRA MOVEMENTS AFTER PATIENTS TAKE MEDICINE.

ANNE'S SYMPTOMS LESSEN IN INTENSITY AS SHE IS TESTED HER ABILITY TO DO BASIC MOVEMENTS DURING STIMULATION.

THE APPOINTMENT IS RELIEF FOR ANNE WHO ARRIVED IN A WHEELCHAIR SUFFERING FROM FROZEN AND PREM MORES BUT LEAVES WALKING.

WITH THE HELP OF HER MEDICATION AND THE DEEP BRAIN STIMULATION.

SO WOULD YOU HAVE EVER THOUGHT WHEN YOU STARRED MEDICAL SCHOOL WE WOULD BE DOING THINGS ON TELEPHONES, ON YOUR PHONES NOW, THINGS LIKE WE'VE SEEN THAT?

AMAZING ADVANCES.

LET ME ASK YOU, THERE HAVE BEEN SO MANY ADVANCES.

WE HAVE A FEW MORE MINUTES HERE.

THERE'S ONE THAT YOU INVOLVE TO SOME EXTENT WITH YOUR SURGERY REFERRED TO AS A GAMMA KNIFE.

TELL ME WHAT THAT IS AND ISN'T THAT SOMETHING OF A MISNOMER.

YES, IT'S NOT A KNIFE.

IT'S ONE OF THE SEVERAL TYPES OF RADIATION THAT CAN BE FOCUSED TO PENCIL THIN BEAMS TO TREAT TUMORS MAINLY.

WE CAN ALSO DESTROY TISSUE IF WE THINK IT IS FUNCTIONING AB NOR NORMALLY.

IT'S AN ADVANCE BUT IT IS NOT REALLY DIFFERENT FROM OTHER TYPES OF RADIATION IN ITS EFFICACY P.

IT'S TOTALLY NONINCE VASIVE.

THAT'S WHY THE TERM GAM MAP KNIFE IS A LITTLE BIT.

SOUNDS KIND OF PRIMITIVE YOU HAVE A KNIFE FOR SUCH A PRECISE TECHNOLOGY.

LET ME ASK YOU BOTH, A LITTLE BIT LESS THAN TWO MINUTES.

SAME QUESTION TO YOU BOTH IF I CAN.

LESLIE, YOU START.

WHERE DO YOU SEE US GOING IN THE VERY NEAR FUTURE COMPARED TO WHERE YOU STARTED IN THIS PROFESSION.

WHERE DO YOU SEE US GOING IN TERMS OF PATIENT CARE AND PATIENT KNOWLEDGE?

WELL, WE'VE BECOME SO DIGITAL WITH WHAT WE EXPECT IN LIFE.

WE DO AFGHANISTAN OFF OF APPS.

WE'RE FULLY EDUCATED CONSUMERS WHEN WE PURCHASE THINGS.

THE SAME IS HAPPENING IN HEALTH CARE WHEN PEOPLE ARE LOOKING FOR A NEUROSURGEON OR FIND OUT THEY HAVE A CONDITION, THEY WANT TO BE FULLY EDUCATED AND INFORMED AND THEY WANT TO FEEL LIKE THEY HAVE A SAY IN WHAT THEY'RE DOING.

BECAUSE AT MOUNT SINAI WE HAVE ALL SORTS OF AMAZING TECHNOLOGIES AT OUR FINGERTIPS AND YOU CAN ESSENTIALLY WALK A PATIENT THROUGH THEIR SURGICAL EXPERIENCE WITHOUT IT ACTUAL HAPPENING, I FEEL THAT WE CAN OFFER A HI-TECH DIGITAL PATIENT SATISFACTION EXPERIENCE.

THAT'S WHAT I'M FOCUSED ON HELPING FOR THE PATIENTS SO THEY FEEL LIKE THEY'RE JUMPING IN WITH EYES WIDE OPEN.

A LOT TO ASK YOU IN 45 SECONDS BUT WHERE DO YOU THINK WE'RE GOING TO BE THE NEXT TEN YEARS IN NEUROSURGERY?

WELL, SURGERY IS STILL A FIELD THAT USES HANDS.

ALL THE ADVANCES SO FAR HAVE BEEN WITH INFORMATION PROVIDED TO OUR EYES.

TO HELP US INTERPRET WHAT WE SEE AND IMPROVE THE QUALITY OF WHAT WE DO WITH OUR HANDS FOR THE PATIENTS.

WHERE I SEE THE NEXT ADVANCES ARE IN HELPING OUR HANDS.

SO WHAT I'D LIKE TO BE ABLE TO BE DO IS TRANSLATE THE INFORMATION ABOUT THE BORDER OF A TUMOR OR THE VICINITY OF AN IMPORTANT ARTERY, TRANSLATE THAT FROM THE SCREEN TO OUR HANDS SO THERE WILL BE DIRECT FEEDBACK INTO THE INSTRUMENTS THEMSELVES EITHER BY PROVIDING A LITTLE PHYSICAL RESISTANCE AS APPROACH SOMETHING DANGEROUS OR GUIDING US PHYSICALLY TOWARDS THE IMPORTANT AREAS WE NEED TO GO.

I WANT TO THANK YOU BOTH FOR SPENDING SOME TIME WITH US.

DR. BEDERSON, LESLIE SCHLACTER, IT'S MARVELOUS WORK THAT'S BEING DONE BY YOU AND EVERYBODY UP AT MOUNT SINAI.

AND YOU KNOW, WE'LL PLAN ON GETTING YOU BACK AGAIN SOMETIME SOON TO KEEP US UP TO DATE ON ALL THE THINGS GOING ON.

THANK YOU VERY MUCH FOR JOINING US TONIGHT.

THANK YOU FOR JOINING US FOR THIS SPECIAL EDITION OF METRO FOCUS.

I WANT TO THANK ALL OF YOU AT HOME.

LET US KNOW WHAT YOU THOUGHT ABOUT TONIGHT'S PROGRAM BY HEADING OVER TOLL METROFOCUS.ORG.

ON BEHALF OF ALL OF US HERE, THANKS FOR JOINING US.

HAVE A GOOD NIGHT.

'METROFOCUS' IS MADE POSSIBLE BY JAMES AND MERRYL TISCH, SUE AND EDGAR WACHENHEIM III, THE SYLVIA A. AND SIMON B. POYTA PROGRAMING ENDOWMENT TO FIGHT ANTI-SEMITISM.

BERNARD AND IRENE SCHWARTZ, ROSALIND P. WALTER, BARBARA HOPE ZUCKERBERG, AND BY --

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