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Portable System Allows Advanced Neurosurgery to Become More Widely Available

It's the size of a laptop computer, but it is as powerful as far larger systems that cost ten times as much and perform the same function - providing neurosurgeons with a tool for navigating one of the most important, and complex, organs of the body, the human brain.

Patrick Kelly, M.D., Joseph Ransohoff Professor of Neurosurgery and Chairman of the Department of Neurosurgery at New York University School of Medicine, invented the new computer-assisted surgical navigation system, called CYGNUS-PFS.

Dr. Kelly's system offers a portable, advanced digital imaging system that precisely guides neurosurgeons to tumors in the brain, sparing healthy tissue. It is the first system of its kind. Unlike currently available digital tracking systems that weigh hundreds of pounds and are the size of small trucks, CYGNUS weighs only ten pounds and, like a small briefcase, easily can be carried. Moreover, CYGNUS costs $40,000 while current systems cost $400,000 to $800,000.

"The size and hefty price tag of the systems now on the market restrict their use to major medical centers," says Dr. Kelly. "I wanted to produce a system that could be easily transported and was affordable. With our new system, patients undergoing brain surgery in smaller hospitals everywhere now can benefit from surgical navigation technology."

Over the past 15 years, neurosurgeons increasingly have relied on digital imaging techniques to track the precise location of surgical instruments in a patient's brain. The techniques depend on powerful host computer systems to process imaging data from MRI and CT scans, which provide maps or pictures of the brain. These computer-generated maps are then used to show the exact position of a surgical probe.

Prior to this technology, many patients with brain cancer were considered inoperable because the surgery was too risky - getting to the tumor would likely mean cutting into healthy tissue controlling vital functions.

However, thanks to the marriage of imaging techniques like MRI and computer electronics, neurosurgeons today know at all times where they are in a patient's brain, and the location of unhealthy and healthy tissue.

Dr. Kelly is an ardent sailor and the inspiration for CYGNUS stems from his experiences sailing. The digital imaging systems used by neurosurgeons are a lot like the handheld global positioning system (GPS) used on boats. The GPS system displays a "fix" of a boat's position in latitude and longitude. Additionally, the boat's position can be plotted on a map, which is similar to the systems now being introduced in luxury automobiles.

CYGNUS, named after Dr. Kelly's sail boat, relies on similar technology. "A neurosurgeon simply pushes a button and the position of a surgical probe is displayed on a three-dimensional map of the patient's brain - a computer -generated picture using imaging data from a CT or MRI scan," says Dr. Kelly.

"The whole idea is to make a chart of the patient's brain. Like a harbor chart, we need to know the location of structures as we navigate," he adds.

CYGNUS employs a laptop computer with 96 megabytes of RAM and a 3-gigabyte hard drive, which serves as a UNIX workstation, and a lightweight electronics control box, which serves as a network integrator. The surgical probe is plugged into this box.

Dr. Kelly says that work is underway to adapt the CYGNUS technology other specialties such as otolarngyology, orthopedics, and spine surgery.

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