“The man who earns a million, but destroys his health in the process is not really a success.” – Zig Ziglar

PNA Spotlight: Dr. Kevin Lillehei

Dr. Kevin Lillehei is chair of the Department of Neurosurgery at the University of Colorado School of Medicine in Aurora, Colorado. He started there in 1985 and his primary work is with benign and malignant brain tumors.  He is also codirector of their Pituitary Center of Excellence, and director of the neurosurgery oncology fellowship.  He did his undergraduate work at Cornell University in New York, where he double majored in physics and chemistry.  He then went to medical school at the University of Minnesota and did his residency at the University of Michigan in Ann Arbor, where he really became interested in pituitary tumors. His mentor was Dr. William Chandler, who, at the time, did virtually all of the pituitary tumors at the University of Michigan.  When Dr. Lillihei left Michigan, he spent two years at the University of Colorado’s trauma hospital, which at the time was called Denver General Hospital. After two years there, he transferred over to the University Hospital.  He was kind enough to answer a series of questions from the PNA about his career.

What inspired you to choose your career path?

At the University of Colorado, they really needed somebody to take over the pituitary tumor surgery part. And I was lucky enough to been at Colorado at the same time as an endocrinologist by the name of Dr. E. Chester Ridgway. And Dr. Ridgway had just come to the University of Colorado from Mass General and the two of us really joined forces and established the pituitary surgery at that time around 1987.  In our pituitary program we do about 140 cases a year, and have a very large network of other interdisciplinary departments that we all work with.

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Virtual reality facilitates pituitary tumor resection

Surgery to remove complex pituitary tumors can be challenging, due to the pituitary gland’s location at the base of the skull. To safely reach and remove the tumor, surgeons need deep knowledge of a patient’s skull base anatomy — especially the course of the carotid arteries, which are located on both sides of the pituitary gland and deliver blood to the brain.

“From afar, all pituitary glands might look the same. But surgery is safest when the surgeon understands unique variations in each individual’s anatomy,” says Dr. Bernard R. Bendok, chair of Neurosurgery at Mayo Clinic in Arizona.

Fortunately, neurosurgeons have new imaging tools. Virtual and augmented reality simulations provide 3D visualization of a patient’s skull base and tumor. The visualizations help the treatment team plan the best approach for each individual.

“It’s important for the team to rehearse and have in their minds a 3D picture of the patient’s microanatomy,” Dr. Bendok says. “Mayo Clinic is one of the few centers that has truly integrated virtual and augmented reality into skull base practice.”

During surgery, 3D visualizations can be superimposed onto the patient’s anatomy. “That gives us a kind of ‘X-ray vison’ to see the artery behind the bones and to avoid injury. We can toggle between the imaging and the patient’s anatomy, which is a big benefit,” Dr. Bendok says.

Projecting the visualization onto screens in the operating room allows the entire surgical team to be more informed and engaged in the procedure. “That leads to more safety and accelerates learning curves,” Dr. Bendok says. “Back when I was training, surgeons looked at the surgical field through their own binoculars. Students in the operating room had limited vision of what the surgeons were actually doing. Now, the whole room can follow every nuance throughout the case.”

Virtual and augmented reality simulations also boost patients’ understanding of their tumors. “All our patients get an avatar built with virtual reality. They can put on a headset and walk around their tumor,” Dr. Bendok says. “For most patients, the skull base is a black box. Visualizing it in 3D helps remove the fear of the unknown, and it makes the patient more of a partner in their care.”

“For surgeons, practice makes perfect,” he says. “But conceptualizing the surgery before it happens — visualizing the procedure and understanding how your hands should follow that vision — is at least as important as technique.”

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Cushing’s can be challenging, but there is support so patients can feel like themselves again. The main goal of treating Cushing’s is to get cortisol levels back to normal. This Pituitary Awareness Month, Xeris Pharmaceuticals® is highlighting the importance of one-on-one support for patients living with Cushing’s Syndrome and support for HCPs treating Cushing’s Syndrome.

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Have more questions? Call for more support at 1-844-444-RCLV (7258)