GW Hospital is a leader in medical technology

The treatment of brain-related diseases and disorders is a delicate art. Neurosurgeons and neurologists train for more than a decade, learning all the complexities of the brain. Fortunately, the doctors at GW Hospital are proficient in advanced techniques for removing tumors and stopping seizures.

Recently GW Hospital announced the addition of an intraoperative MRI to its Neuroscience Institute. This will enable surgeons to view high-resolution images of the brain while a patient is undergoing surgery.

“Having updated images during brain tumor removal helps us provide safer surgery,” said neurosurgeon Dr. Carlos Sanchez. “This capability really brings the operating room to the MRI scanner and back.”

Brain tumors can cause a variety of concerning symptoms that interrupt a patient’s life, such as cognitive dysfunction, weakness and seizures. For a successful tumor removal doctors need to accurately identify the tumor and then remove exactly the right amount of tissue while not damaging healthy tissue in the process. At GW Hospital, neurosurgeons like Dr. Sanchez use the NeuroBlate® system, an innovative procedure where only a small (less than one centimeter) incision is made, instead of a larger incision and craniotomy, where part of the skull is removed to expose the brain. The recovery time for this type of tumor removal is significantly shorter, meaning patients may get back to their lives quicker and with fewer stitches.

Using a robot-guided laser catheter, Dr. Sanchez and his colleagues access tumors through a very thin port. Then, they gradually raise the temperature within the tumor itself until the cells die. “We typically send patients home the next day,” Sanchez says. “With literally one stitch, we’ve accomplished what a cranial surgery would do.”

Seizures, which are caused by abnormal electrical activity in the brain, can originate from a variety of different brain regions and can return over time, even after successful procedures. Identifying the “seizure onset zone” of the brain is one critical element in successfully treating seizures. At GW Hospital, neurologists like Dr. Mohamad Koubeissi deploy artificial intelligence to help correctly identify the seizure focus.

“We teach the artificial intelligence with MRI images of individuals with both left hemispheric and right hemispheric epilepsy,” Koubeissi says. “Then the AI can tell us whether a patient has no epilepsy or right hemispheric or left hemispheric epilepsy. Eventually, it will tell us not just the side of the brain, but also which particular area is producing the seizures.” This technology leads to better surgical outcomes and a higher likelihood that a patient becomes seizure-free without additional surgeries.

The heart pumps out oxygenated blood to the rest of your body through its left side, then receives already-circulated blood through its right side. The heart’s pumping tempo is directed by its own electrical system. At GW Hospital, cardiologists work together across disciplines to help ensure all the heart’s parts work together seamlessly.

Atrial fibrillation is the most common abnormal heart rhythm and is associated with a variety of factors such as hypertension, obesity and sleep apnea. Depending on the type of irregular heartbeat, cardiologists sometimes use a technique called ablation, in which doctors scar selective heart tissue to block irregular electrical signals. The scarring is usually done with a hot energy source, but GW Hospital is one of the first institutions in the region to use cryoablation, which instead delivers cold lesions to the heart muscle.

“You get a very durable, circumferential, uniform lesion when you use cold,” says cardiologist Dr. Cynthia Tracy. “You avoid spotty lesions. That’s why it’s our go-to, main energy source.” A durable lesion means the chances of needing a repeat procedure in the future are much less.

When a patient is experiencing a heart rupture or blockage, doctors need access to the organ’s intricate system of valves hidden behind the ribcage. Recent technology allows doctors to deliver certain therapeutics through minimally invasive procedures instead of open-heart surgery. Doctors at GW Hospital were some of the first in the region to operate on Zone Zero, a difficult to reach area at the bottom of the aorta, which is the body’s largest artery and the point at which blood first exits the heart.

“We are now using innovative grafts, called side branch grafts, where we put a graft into the head vessels without covering them,” says Dr. Farzad Najam. What’s more, the procedure utilizes a catheter fed through the femoral artery, which means the surgeons don’t need to open the chest.

We’re all told to watch what we eat. For gastrointestinal surgeons, their job is to watch how we eat. They follow the path our food takes, the twists and turns from mouth to intestines, and fix any issues along the way, including trouble swallowing, difficulty absorbing nutrients and more. At GW Hospital, physicians like Dr. Vaziri use high-tech visualization tools and minimally invasive techniques to help ensure food goes down, stomach acid doesn’t go up, and your stomach wall remains intact.

A laparoscope is a thin tube with a camera and light that allows surgeons to see inside your body – and perform a variety of surgeries – through a very small incision (around 5 millimeters). Today, gastrointestinal specialists at GW Hospital are pushing the procedure forward with high-resolution, 3D visuals for nuanced, complex reconstructions. “These types of operations can lead to a faster recovery, less pain, better visualization and overall better outcomes,” says Dr. Vaziri. This may include an earlier return to normal life for the patient.

With better visualization and more complex surgeries, surgeons need better instruments. In the past, laparoscopies involved essentially a straight stick with a grasper or scissor on the end. Today, however, tools are angular and wristed, allowing for more degrees of movement within the cavity and more nuanced incisions.

One such surgery is the peroral endoscopic myotomy (or POEM) used to treat a foregut disorder called achalasia, which restricts the sphincter below the esophagus and blocks food and liquids from getting into the stomach. Better tools and newer techniques allow doctors to cut that sphincter without making an incision on a patients abdominal wall, which could mean less scarring and less time in the hospital for patients.

Problems in the urinary tract can have an outsized impact on a patient’s quality of life. Having to worry about the involuntary release of urine – due to bladder issues, spinal cord injuries, or structural scarring from traumatic injuries – makes every other aspect of life more difficult. Fortunately, urologists like Dr. Daniel Stein are making tremendous progress in restoring control of our bodies’ waste systems through new procedures and reconstructive surgeries.

The ability to properly hold and release urine at the right time requires a complicated, synchronous collaboration between our brains, our spinal cord, the nervous system, and our urinary organs. Any disruption in that relationship can lead to issues. Specialists like Dr. Stein are highly-skilled in that careful interplay.

One procedural example is a sacral nerve stimulator, which urologists implant near the spinal cord to stimulate the nerves that connect to the bladder. “The bladder is a muscle, so the idea is to essentially calm that muscle down,” says Dr. Stein.

When most folks think of Botox®, it’s usually for cosmetic purposes. But recently, physicians have begun using it to moderate an out-of-sync bladder by helping to calm overactive bladder muscles. Using a cystoscope, a small camera is inserted through the urethra, urologists can inject Botox® directly into the wall of the bladder. “It’s particularly useful since it doesn’t have systemic side effects, like a lot of other medications,” says Dr. Stein.

Each one of these advances and technologies is remarkable in its own right. But taken together, the net impact on patient care is ultimately more nuanced, more personalized treatment. All our bodies are different, and our illnesses are unique. With greater expertise, more capable tools, improved training and education, and interdepartmental collaboration, the doctors at GW Hospital are able to tailor their treatment pathways to the individual condition, helping to improve outcomes, reduce complications and recovery times, and ultimately help get patients back to their lives more effectively.