Coming Soon: the ‘Gamma Knife’

A $3-million device that enables doctors to do brain surgery without a scalpel--instead, cutting out tumors with finely focused rays of radiation--will be installed at Western Medical Center in Santa Ana, one of six hospitals in the United States to be chosen for the technology.

The device, generically called the “gamma knife,” can even be used on patients with previously inoperable brain tumors because the radiation will not harm surrounding, healthy tissue, according a spokesman for the Swedish manufacturer.

Patients, who could also include people with eye and ear tumors, will undergo a procedure of only about 20 minutes and can go home the same day or the next, slashing costs and reducing the potential for complications.

The selection of Western Medical Center for the gamma knife was announced Thursday night by Wayne Schroeder, president of United Western Medical Centers, at the annual meeting of the hospital’s medical staff.

“This is 21st-Century technology,” Schroeder said in an interview.

A section of the hospital, next to the lobby, will be adapted for the gamma knife at a cost of $500,000. It should be open in about a year, and hospital officials foresee eventually treating about one patient a day with the gamma knife, which also will be used for research.

Currently, only five places in the world have the machine, called the Leksell Stereotactic Gamma Unit. The only American institution that now has the device is the Presbyterian-University Hospital of Pittsburgh in Pennsylvania.

According to literature about the machine, the patient’s head is placed inside a large metal helmet resembling an oversized hair dryer with 201 holes. Through those holes, gamma rays the size of hair follicles are directed at the tumor. Doctors and technicians guide the rays, using a 3-dimensional computer picture of the patient’s head. It is painless and anesthesia usually is not required.

The radiation does not damage the healthy tissue because each ray is of low dosage, according to S. Lewis Meyer, president of American Health Services of Newport Beach, which represents the manufacturer, Elekta Instrument AB of Stockholm. However, when the rays converge at the tumor site, the radiation is of such high intensity that “it acts as a surgical tool” and the abnormal tissue is destroyed, Meyer explained.

In addition to tumors of the brain, eye and ear, the gamma knife also could be used to treat such dangerous brain blood vessel conditions as arteriovenous malformations, which are masses of engorged blood vessels that could burst, officials said.

Each treatment is expected to cost about $15,000, according to hospital officials.

Schroeder said brain surgery “can sometimes go to six figures” when extended hospitalization and therapy is involved. He said medical insurance and Medicare will pay for the gamma knife surgery because of its cost-effectiveness.

While it cannot be used to remove all brain tumors, the technique virtually eliminates the risk of infection, bleeding, seizures and harm to surrounding tissue (often resulting in brain damage) that can accompany conventional surgery when the skull is cut open and a tumor is sliced away, officials said.

“For people with conditions without hope, this offers them hope,” Schroeder said. “And this gives others who need surgery options.”

Schroeder said Western Medical Center was chosen for the device by American Health Services Corp., which will be a partner in the venture, and a medical team. Dr. Robert Rand, a UCLA professor of neurosurgery who trained under Dr. Lars Leksell, inventor of the device, and Dr. Deane (Skip) Jacques of Huntington Memorial Hospital in Pasadena, will perform the bloodless surgery and will work with the hospital’s neurosurgical staff.

Other gamma knife devices will be installed at the Mayo Clinic in Minnesota and in Virginia, Chicago and Dallas, Schroeder said. The machine will not become common at hospitals because it is too expensive and the training to use it is too specialized, he suggested.

Schroeder said he foresees the device attracting patients to Western Medical Center from throughout the western United States, many of them referred by insurance companies.

He said he did not know which other hospitals in the greater Los Angeles area were considered for the device, but he believes that Western Medical Center was chosen because of its reputation for being in a leader in high technology and specialized care.