Making a bloodless cut with a 20-ton knife

A 20-ton knife is not a common sight in Philadelphia, but a local hospital will soon be using one to treat patients -- and doing it without making a single cut.

Pennsylvania Hospital, located in Center City and operated by the Penn Health System, unveiled its celebrated state-of-the-art machine, known as a gamma knife, last Friday. The 20-ton knife will be used to treat brain diseases such as cancer and vessel abnormalities.

Much to the delight of its patients, it does not cut.

In lieu of a knife to treat a particular area of the brain, the gamma knife emits a beam of radiation.

This beam is able to generate a high dose of energy, which the machine directs to the targeted site.

In a process termed stereotactic surgery, the coordinates of the diseased area of the brain are obtained and plotted to allow precise targeting for treatment.

First developed by Swedish neurosurgeon Lars Leksell, the technology has been around for nearly 30 years. However, its usefulness has been maximized with recent advances in imaging techniques.

Vice Chairman of the Neurosurgery Department Peter LeRoux likened the precision of the gamma knife procedure to that of global-positioning satellite systems.

Compared to surgery with a knife, the patient experiences less discomfort, reduced hospitalization and recovery time and reduced risk of complications.

Moreover, the knife is a viable option for patients with inoperable tumors or medical conditions that preclude surgery.

Still, LeRoux added that the gamma knife is not a cure-all and is another treatment option, not a replacement for neurosurgery.

He stressed that expertise in designing a treatment plan requires a multifaceted approach.

"A fool with a tool is still a fool," LeRoux said.

Pennsylvania Hospital's gamma knife is housed in the hospital's Spruce Building. It was installed slightly over a month ago.

Fran Ambrose is the owner of Ambrose Rigging, the company that installed the gamma knife.

"It went according to plan," Ambrose said, adding that the company moves heavy pieces of equipment every day.

He said that it took very little time to install the machine and that the key to moving equipment like the gamma knife is to have a well-thought-out plan and to watch your "P's and Q's."

While Penn initially advertised its gamma knife as the first robotic model in the region, the honor actually belongs to Temple University Hospital, which announced its acquisition and installation of a gamma knife before Penn did.

Curtis Miyamoto, co-director of Temple University's Gamma Knife Program, treated his first gamma-knife patient in late August and is delighted by Penn's latest acquisition.

Miyamoto sees Penn's gamma knife not as a threat, but as an added benefit to everyone in the Philadelphia community.

"I am glad we both have it," Miyamoto said. "Every patient deserves the best."

He added that the new gamma knives at Penn and Temple will encourage other institutions -- such as Thomas Jefferson University Hospital at 11th and Walnut streets, which owns an older gamma knife -- to follow suit.

However, Miyamoto added that Penn lacks a machine called Synergy S. This device would complement the gamma knife by offering similar treatments, but to areas outside the brain.

Penn's gamma knife is fully operational, although it will not be treating patients until November.

Projected patient numbers for the first year are about 100, settling at about 200 patients per year thereafter.

Please note All comments are eligible for publication in The Daily Pennsylvanian.