Marcus Barnes couldn’t have envisioned what he was about to see.
One month after successful brain surgery, the Irvine resident sat in an
operating room at Hoag Hospital Newport Beach and was handed a pair of
virtual reality goggles.
“There’s your long-gone nemesis,” said Dr. Christopher
Duma, neurosurgeon and medical director of the brain tumor program at
“Oh my gosh. This is so cool,” Barnes, 41, said over and over.
“This is truly amazing.”
What Barnes saw was a first-hand look at the tumor that was removed from
his head – appearing lime green in the 3D model and sitting near
a tangle of blood vessels.
Barnes’ virtual-reality trip was built with new technology called
Surgical Navigation Advanced Platform, or SNAP, which Hoag brought into
the operating room in January. SNAP uses diagnostic images physicians
already order, like magnetic resonance imaging (MRIs) and computed tomography
(CT), and creates a 3D model that can be used to plan brain surgeries.
Surgeons can manipulate the model on a touchscreen, or wear Oculus Rift
virtual reality goggles to do a “fly-through” of the procedure.
Hoag became the first non-academic medical institution on the West Coast
to use the technology.
Dr. Robert Louis, a neurosurgeon who performed Barnes’ surgery, said
he’d planned to access the tumor through Barnes’ eyebrow.
But when he looked at the tumor using the 3D model, Louis realized part
of the tumor was blocked by Barnes’ optic nerve and would have to
be left behind.
By turning the image, he realized he could better reach the tumor –
all of the tumor – from the side without affecting any surrounding
“I wouldn’t have known I couldn’t get (the bottom of
the tumor) just using the 2D images,” Louis said. “It’s
a game changer. Kids playing video games have had this technology for
10 years. It’s amazing we only now get it in the (operating room).”
Typically, a complete change of surgical approach in the final hours before
surgery would make patients nervous, Louis said. But with Barnes, he just
wheeled out the monitor to his bedside and showed him the change. Barnes
still has a video of the surgeon’s explanation on his phone.
“Surgeons get used to seeing things in two dimensions, but the patients
don't. But with the 3D model, they understand like that,” Louis
said, snapping his fingers.
The technology, which developers say is partially based on F16 fighter
jet simulation, cost Hoag about $500,000, according to Carole Metcalf,
executive director of perioperative services at Hoag. Each 3D model takes
five to 15 minutes to build in the program, said Jay Sanchez, Western
U.S. regional director for SNAP company Surgical Theater.
Duma said the hospital has used the imaging software for about 20 surgeries so far.
“We use it for every single tumor case,” Duma said. “Why
would you not?”
Tumors aren’t the only application for SNAP.
Duma pulls up another case on the screen – a patient with trigeminal
neuralgia, or burning pain caused by a facial nerve. He said with SNAP
he was able to see exactly where a small blood vessel crossed the nerve,
and avoid it.
There are also plans to see if it will work for spinal surgeries, he said.
“It’s a brave new world,” Duma said.
Barnes said he has completely bounced back. He’s back at work, and
just four weeks after his surgery ran just over nine miles. The plan is
to run 15,000 kilometers by the time he’s 45, or just over 9,300
miles, he said.
The tumor, he found out recently, was benign. The only sign of the surgery
is a Nike swoop-shaped scar down his hairline.
“I just feel so blessed,” Barnes said.
He jokes that he’s glad his eyebrow was spared, and he can still raise it.
“I can still be skeptical,” Barnes said.
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