Thursday, November 28, 2013

EU: Sure BDS us and don't make use of the following for your ailing citizens

Noninvasive Brain Surgery

Medical history was made at Rambam Health Care Campus last week when an Israeli essential-tremor patient successfully underwent targeted surgical ablation of deep-seated brain tissue through an intact skull, a radical therapy made possible by the marriage of MRI-guidance and ultrasound-ablation technologies.

It has been years since Mr. Sami Zangi, 73, of Jerusalem, could bring a cup of coffee to his lips, tie his shoelaces, or most frustrating of all for this hardware store owner, use the simplest tools. A week ago, when Mr. Zangi asked to communicate something in writing to his Rambam doctors, his hand shook so badly that he could only produce an illegible scrawl.

Mr. Zangi suffers from essential tremor, a slowly progressive movement disorder whose cause lies deep within the brain. Last week, after MRI-guided Focused Ultrasound Surgery (FUS) at Rambam Hospital, Mr. Zangi got up from the MRI table tremor-free, smiled, and again requested paper and a pen. "Remember what I tried to tell you a week ago?" he asked. Surrounded by his wife and family, he wrote in a steady and beautiful hand, "If you will it, it is no dream" (ed. note: Theodor Herzl).

First Time Ever in Israel: Noninvasive Brain Surgery
First Time Ever in Israel: Noninvasive Brain Surgery
ExAblate Neuro is the trade name for the noninvasive surgical treatment that Mr. Zangi underwent. The procedure, which targets and ablates brain tissue through an intact skull, has been made possible by the marriage of MRI-guidance and ultrasound-ablation expertise. 

The patient spent three calm, wide awake hours inside an MRI machine, communicating with and monitored by Senior Neurologist Dr. Ilana Schlesinger, Head of the Movement Disorders and Parkinson's Center, while Prof. Menashe Zaaroor, Director of the Department of Neurosurgery, used a computer mouse to direct 1,000 ultrasonic beams to the thalamic focal point targeted for thermal ablation.       

The pioneering technology was developed in Israel by InSightec. The company was founded in 1999 with the visionary idea of applying ultrasound expertise to noninvasive surgery.  "We are the only company with the technology to provide noninvasive ultrasound therapy in the brain," says InSightec Vice President of Research & Development Mr. Eyal Zadicario.

"It's a brilliant idea," said Prof. Dorit Goldsher, Head of MRI at Rambam. "The brain is enveloped with hard bone, and the idea is to operate without touching the bone. It's a dream come true." 

Neurosurgeon Prof. Michael Schwartz of the University of Toronto and Sunnybrook Health Sciences Centre flew to Israel in order to observe the procedure at Rambam. He has performed the same procedure on six patients at Sunnybrook using earlier-generation software by InSightec and wanted to be present at the newest software's world debut.  "In essential tremor, the neurons are too active; they fire in symmetry at several cycles per second," he explained. "We know that making a lesion interrupts the circuit. It's like cutting a wire; we're cutting the neural pathway that causes the tremor."

Dr. Schlesinger expressed the elation in the MRI control room at Mr. Zangi's immediate, noticeable improvement in tremor and return of functionality. "The fact that an Israeli company has developed this technology, and that we have performed this procedure on an Israeli patient at Rambam, shows what we can achieve as a nation if we pursue our dreams."

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