In an Australasian first, neurosurgeons at Macquarie University Hospital have introduced the BrainPath® non-disruptive cranial access technology, a new device allowing access to tumours deep within the brain without causing damage to surrounding tissue.


The first patient treated with BrainPath at Macquarie University Hospital was diagnosed with a 12mm metastatic adenocarcinoma in the right frontal lobe, pressing against vital motor pathways of the brain.


She probably would have been advised against surgical removal of the tumour before the arrival of BrainPath and a new standardised surgical approach that integrates BrainPath with imaging, navigation and tissue removal technologies.


Importantly, BrainPath allows surgeons to access deep regions of the brain using its natural folds – a trans-sulcal surgical route.


The technology is essentially a highly engineered metal probe that lies inside a 14mm-wide plastic sheath. The probe, which is uniquely navigable, guides the sheath to the targeted abnormality then is removed, leaving the sheath as the corridor by which surgeons use existing instruments to remove tumour or hematoma within the brain.


“The genius of BrainPath is its ability to pass between the ‘sulci’ or folds of the brain, applying uniform pressure in all directions as it moves around tissue,” said Dr. Andrew Davidson, who performed the procedure after receiving specialised training in the US.


“The probe is linked to a real-time intraoperative 3-D MRI navigation system, allowing surgeons to see exactly where they are operating.”


The BrainPath is manufactured by NICO Corporation, a world leader in developing non-invasive neurosurgical surgical systems and a new novel standardized surgical approach using advanced technologies.


It is significant in offering safer surgical opportunities for those patients who have gliomas, secondary metastatic tumours and other tumours inside the brain.


“Previously, even though we have been using minimally invasive approaches to brain surgery for more than a decade, removing a lesion often involved cutting away tissue to get to the tumour,” said Dr. Davidson.


“This conventional method poses risk to critical structures of the brain that might get permanently damaged in the process, and in cases like our first patient, we would have been limited in terms of what we could reach.”


Recovery for patients who undergo surgery using the BrainPath Approach is much faster, often resulting in reduced time in hospital.


The BrainPath device has also been approved for early clot removal in cases of intra-cerebral haemorrhage – the deadliest and most debilitating form of stroke. There is now a growing body of peer-reviewed evidence showing improved patient outcomes for both tumour removal and hemorrhagic stroke when using BrainPath.


Research from the US, where the technique has been in use since 2015, shows length of hospital stay after haemorrhagic stroke has reduced from 5.2 days to 2.8 days and time spent in the ICU has also dropped from 1.7 days to 0.9 days.


In the UK, Kings’ College Hospital in London became the first medical centre to work with the device earlier this year, and it has gained the CE Mark (European Conformity), which recognises the technique for use in more than 30 countries in the European Union.


Jim Pearson, President and CEO of NICO Corporation, said: “NICO is highly committed to the training aspect of this new approach and technology to ensure surgeons are performing surgery in a standardised way using standardised technologies to achieve repeatable clinical results.


“We are very excited that the population around Australia will now be able to benefit from these technologies and a new surgical approach that is better for the patient and the healthcare system.”





The clinical and research lymphoedema team from the Faculty of Medicine & Health Sciences at MQ hosted international guests to complete an intensive week of surgical training, rehabilitation management, education and research collaborations. The MQ team welcomed Associate Professor Håkan Brorson from Sweden who is the founder and leader of liposuction for lymphoedema surgery across the world. Brorson has successfully completed liposuction for over 21 years in Sweden and has extensive research data and publications showing the positive outcomes of his program. Brorson trained members of the MQ team 3 years ago and was instrumental in imparting his knowledge, skills and experience to our team in making the Australian program so successful.

Prof John Boyages. Associate Dean, International & Engagement and Lymphoedema Program Director said “It was an intense week of activities, but linking in with the “Father of Liposuction for Lymphoedema” was an enormous honour”.  He was extremely impressed with our program and a future research collaboration has been initiated. Prof Brorson is the current President of the International Society of Lymphology.

From left to Right: Professor John Boyages (Lymphoedema Program Director), Dr Meredith Simcock (plastic surgeon from NZ), Prof Hakan Brorson, Dr Alessandra Canal (plastic surgeon from NZ), Lymphoedema therapist Peggy Williams, Louise Koelmeyer (Lymphoedema Program Manager) and Dr Thomas Lam (Liposuction plastic surgeon, MUH).

Currently Macquarie University Hospital (MUH) is the only facility in the Southern Hemisphere to offer liposuction for eligible lymphoedema patients, and 25% of the clinic’s patients have had to travel from interstate and two even from New Zealand. We welcomed a team of two plastic surgeons and a lymphoedema practitioner from New Zealand who were sponsored by the New Zealand Breast Cancer Foundation to be trained in offering a liposuction for lymphoedema program during Brorson’s visit. “Our team are now leaders in this practice in their own right, having successfully launched our program three years ago and building our own expertise in an entirely different climate to Sweden. We are now sharing our expertise with a team of clinician contacts based in New Zealand,” said Louise Koelmeyer, Lymphoedema Program Manager of the MUH program.

Lymphoedema may affect individuals physically, functionally and psychologically and is often a daily reminder of their cancer diagnosis and treatment. Despite early detection and intervention being a key component of management, the need for a surgical approach for advanced fatty lymphoedema using liposuction is important. Over the last 3 years data collated by research & medical staff at Macquarie University Hospital has shown that liposuction surgery was performed on 35 eligible lymphoedema patients which had a success rate of nearly 100% volume reduction and significiant physical, functional and psychological gains, in one case relieving a patient of nearly eight litres of excess fat in her right leg.

During the week the team completed liposuction surgery on 2 cancer survivors from Queensland. One had 2 litres of fat removed from her arm and the other had 10.5 litres of fat removed from her leg. This was the largest leg operated on by the MQ liposuction team and the 2nd largest leg for Brorson in his 21 years of completing the surgery. Both women were delighted with the initial results and have been discharged to recover and rehabilitate back home. They will make regular trips every 3 months to MQ for the first two years after surgery so that measurements can be taken for custom made compression garments which is an integral component of the long term success of the surgery. Koelmeyer says the liposuction treatment is an unexpected approach to lymphoedema management, but the results speak for themselves and have been life changing for so many.

Another highlight of the intensive week’s program was the delivery of a whole day “health professional” and afternoon “consumer” forum. Presentations were given by medical and allied health clinicians, researchers, basic scientists and a PhD student. The topics included cancer and lymphoedema treatments and care, basic science research outcomes, new research data and patient support and advocacy.
One hundred and thirty health professionals from varying disciplines (lymphoedema therapists, nurses, psychologists, medical practitioners) and eighty consumers attended the forums.  “We were excited to host a broad range of lymphoedema stakeholders and presenters at our Forums including sponsors Macquarie University, Sydney Vital and Smith & Nephew.  We were particularly glad to welcome Associate Professor Håkan Brorson to present at both forums which was very well received. There were some MUH patients in attendance who thanked Brorson for his initiative and insight into developing the liposuction program which has changed their lives for the better.

Both sessions facilitated the shared learning of current best practices for patient outcomes and care. With the spread of these treatment advancements such as the liposuction technique it I important for practitioners to know what best practice options for management are available. There were interactive case presentations and panel discussions so that audience participation was encouraged in asking questions to the speakers. At the closing of the Forum both Associate Professor Brorson and the medical lead of MQ’s advanced lymphoedema clinic, Dr Helen Mackie were given life-time achievement awards by the Faculty of Medicine and Health Sciences on their outstanding contributions to lymphoedema.

On the final day of the week’s program the international visitors attended the multidisciplinary team meeting and clinic where they observed and interacted with patients attending for assessment and follow up. Overall an enriching and wonderful experience for all who participated in the extensive week’s program. Strong partnerships and research collaborations were formed.


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