The Neurosurgical Operating Suites

Cross the threshold into Bay’s two neurosurgical operating suites, and you’ve stepped into the future. Both suites were designed as integrated surgical settings to accommodate the BrainLab that allows pre-operative CT or MRI patient images to be captured in DVD format system. Through this system the surgical treatment plan is made.

The system continuously provides data back to the surgeon, so he/she knows at all times where they are in relationship to a tumor, for instance, as well as vital structures near the operating site.

Surgical images can be viewed from the Zeiss multi-vision microscope. Images are delivered through ceiling mounted computer monitors that provide real-time, on-demand data.

The entire system can be moved to allow the neurosurgeon the most ideal trajectory for entering the brain or spinal cord, using minimally invasive techniques, when possible. At every point, the neurosurgeon, anesthesiologist, and OR team can see the procedure and anticipate instruments or devices needed for intervention.

• Craniotomies (opening the skull to expose the brain for tumor removal or to clip a bleeding aneurysm in the brain and prevent or minimize stroke impairments).
• Skull-base surgery (to address tumors or blood vessel abnormalities at the base of the skull. These can include pituitary tumors, or deep-seated aneurysms.
• Carotid endarterectomy (removing plaque that is stopping blood flow from the carotid artery to the brain).
• Subdural hematomas (Often the result of a closed head injury or brain trauma). The blood clot causes an increase in pressure on the brain.

The neurosurgical suites are also used for a variety of spine surgeries.

One such procedure is a kyphoplasty. The neurosurgeon repairs spinal vertebral compression fractures with a balloon. In this procedure, two small needles are inserted through a puncture in the skin. A small working channel is passed into the fractured vertebrae. A bone biopsy may be done. Then, two very strong balloons are inserted and inflated to reduce the fracture, and restore spinal alignment.

The balloons are then deflated. The small cavity left in the fractured vertebra is filled slowly and carefully with medical grade cement. The cement hardens in minutes, and the spine has greater strength and stability to the spine.

Most back surgeries are done on a Jackson Spinal Table that allows customized 360-degree positioning, a radiolucent frame and support pads, and unrestricted C-arm integration. It provides optimal spinal surgery positioning for the patient. Lumbar procedures can include:

• Spinal decompressions (minimally invasive endoscopic procedure for herniated discs to either remove a portion of the nucleus in the affected disc, to manipulate a disk back into place, or to remove bone fragments and spurs).
• Laminectomies (a procedure for spinal stenosis to relieve pain where bone is impinging on the nerve. A small portion of bone impinging on the nerve root or disc material from the nerve root is removed to give the root more space).
• Anterior or posterior spinal fusions (One or more vertebrae are fused together to treat broken vertebrae, correct deformity, treat instability or pain, or treat a herniated cervical disc).
• Kyphoplasty (minimally invasive procedure for spinal fractures caused by osteoporosis or cancer).
• IDET surgeries (a minimally invasive treatment for chronic low back pain for certain types of degenerative disc disease).
• Removal of spinal tumors

While the neurosurgeon and anesthesiologist lead the intervention, the scrub personnel and circulating nurses are specially trained on the room’s equipment -- every instrument, and all hardware needed for each procedure. The entire team has the stamina to stay engaged in complex brain or spinal surgeries, and the ability to respond quickly in emergency situations.

Neurosurgical Nursing Coordinator Lori Majeske, CNOR, says: "Our surgical nursing team knows that seconds count, whether it’s brain or spinal cord surgery. Sometimes the pre-op team has just minutes to get a patient ready to enter the OR. Our nursing teams are on call 24 hours a day.

"The OR neurosurgical nursing team makes sure all systems in the room are ready, that blood is on hand if needed, that assistance is available for anesthesia and scrub technicians. Every neurosurgical team member has worked alongside each neurosurgeon, and is intuitive to particular preferences, tools, and surgical strategies, so the most optimal patient outcome occurs."