Brain Biopsy

What is the incidence of brain biopsy in the United States?

What challenges have been encountered with conventional surgical approaches?

1. Invasive – Limited by lesion location due to risk for morbidity²
2. Under-grading disease⁴ – Sampling error^2,3 – Scant tissue retrieval²
3. Blinded approach – Relies on the accuracy of neuro-navigation²
4. Hemostasis management with no direct visualization²
5. Cannot offer symptom relief – Incapable of palliative mass effect reduction

How does the MIPS approach with NICO’s integrated systems solution overcome these challenges?

Challenge #1 – Invasive

Solution: Minimally disruptive, navigable access to eloquent areas with BrainPath

Challenge #2 – Under-grading disease, sampling error, scant tissue retrieval

Solution: High yield tissue collection with NICO Myriad NOVUS and Automated Preservation System

• Myriad NOVUS tissue filter ensures all tissue resected is collected for post procedural use.
• Myriad NOVUS tissue trap holds ~ 10cc of tissue and the clear-housing provides for easy viewing of the volume collected during the procedure.
• Myriad NOVUS resects tissue in a mechanical, non-ablative and non-thermal format so the cellular viability of the specimen is still maintained with minimal crushed artifact. With the cutter engaged, the Myriad is capable of 1,400 bites of tissue per minute.
• Myriad NOVUS collects all tissue that is resected through the device in a sterile, closed tissue trap that mitigates tissue degradation by limiting the sample’s exposure to the atmosphere.
• Myriad NOVUS with the Automated Preservation System (APS) automates and standardizes the intraoperative process of tissue resection, collection and biological preservation, eliminating the need for a full time employee to do so.
• Myriad NOVUS with the APS allows for efficient automated collection of a greater volume of tissue while creating a biologically friendly environment for use in patient specific tissue studies and protocols.

Challenge #3 – Blinded approach

Solution: Direct visualization and real-time intraoperative imaging solutions

• HD optics with exoscopes have shown equal light delivery and magnification down the BrainPath sheath corridor without occupying space within the sheath.

• BrainPath compatible ultrasound probes fit into the sheath corridor to make direct contact with the surgical site, which can aid in visualizing nearby anatomy surrounding and below the sheath, as well as monitor resection.

Challenge #4 – Hemostasis Management

Solution: Bimanual microsurgical technique

• Both BrainPath diameters can accommodate two hands in the surgical field to enable basic hemostatic principles of microsurgery to be applied.
• Surgeons use a modified bipolar for arterial bleeding and tamponade with hemostatic agents and warm saline irrigation for venous bleeding.⁵

Key Publications

Citations