Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Dr. Meysam Kebriaei, Medical Director of the Neurosurgery Program at Children's Minnesota

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Dr. Meysam Kebriaei, Medical Director of the Neurosurgery Program at Children's Minnesota · Becker’s Healthcare -- Pediatric Leadership Podcast

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  This is Alan Conlin with the Becker's Healthcare Podcast,
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  and I'm thrilled to be joined today by Dr. Mason Kire,
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  medical director of the neurosurgery program at Children's Minnesota. Uh, Mason,
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  before we dive into our discussion today,
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  I'd love to turn the floor over to you here a little bit about your role and of
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  course, your background.
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  Sure, of course. Thanks for having me. Uh, my name is Mason Kire,
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  like you mentioned. Uh, I've, uh,
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  been a pediatric neurosurgeon for a little over 10 years now. Uh,
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  before that obviously seven year residency year fellowship, and then, uh,
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  the 10 years in practice at Children's Minnesota. Uh,
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  and I've been the medical director here for about a year and a half.
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  We have one of the largest, uh, programs, uh, neurosurgery,
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  pediatric neurosurgery programs in the, uh, in the state. And I'm, uh,
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  I'm very proud of, uh, the services we, we have to offer our, our patients.
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  Fantastic. So yeah, let's dive right into that. Exactly. Uh,
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  children's Minnesota, like you'd mentioned, open, uh,
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  an MRI neurosurgery suite this year.
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  Can you give us a little bit of insight into about that suite and how it's
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  improving patient care?
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  Absolutely. This is a piece of technology that we're really excited about,
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  not just in our department, but really as an institution, uh,
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  for our community and,
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  and our patients in the state and in the region as well too. So we have a, uh,
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  one of its kind intraoperative MRI suite, uh, and, uh, the,
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  the idea of an intraoperative MRI suite, even though it's novel,
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  it's been around for, um, you know, a few years. But, uh, what makes our mri,
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  uh, suite special and, uh, the, the only one of its kind is that we,
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  we have three rooms attached to it. So the mri, uh,
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  stays in a room where we can do diagnostic imaging.
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  So patients come in from outside,
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  they can get imaging of their brain in spinal cord. Uh,
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  and then in the meanwhile, it's attached to two operating suites altogether,
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  about 3000 square foot, uh, rooms. And so, uh, we,
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  we can do surgeries in these rooms and, uh, and get an,
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  and when we're done with the surgery, we can get an MRI before we close.
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  And really, uh,
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  I look at the MRI and we can have our radiologist look at it as well too.
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  And at the point of, uh, treatment,
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  we can look and make sure we've removed all the tumor. For example,
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  if it's a spinal cord tumor,
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  we've removed all the tumor that we wanted to see for removed and that there's
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  no complication, like a postop blood clot or a hematoma that we need to address,
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  uh, before we close up. And really, it, uh, it, it's,
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  it's very exciting to be able to offer, offer this to our, to our patients.
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  Yeah, I mean, sounds like a huge, a huge, hugely exciting piece of technology.
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  Can you break it down, I guess, uh, you, you've touched on kind of the,
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  some of the benefits and advantages there,
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  but how has this really affected your workflow patient care?
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  What are the biggest advantages, I guess, you're seeing, uh, for the,
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  from the surgeons aspect,
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  in terms of how you're operating in this new MRI and sleep compared to how you
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  were operating before?
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  Well, I would say, you know,
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  in 2023 to get the best outcomes for patients in any field,
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  especially ours, is that you have to have the right people,
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  but also the right technology, you know,
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  and I really truly believe that we have the right people that are able to offer
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  our patients the best care, but also we've got the best latest technology.
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  So this intraoperative MRI suite really allows us to,
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  to make sure that we give our patients the best chance of the best outcome that
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  we can give 'em. So in the case of a spinal cord tumor, the,
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  the number one prognostic factor for survival is the
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  extent of resection to how much tumor we remove. And a lot of times,
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  spinal cord tumors on their microscope,
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  they look very similar to normal spinal cord tissue.
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  And a spinal cord is very small and very thin. And so the, you know, the,
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  you really aren't, there's not really a lot of margin for error. And the,
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  with intraoperative, uh, mri, once we, we, we are done under the microscope,
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  looks like we've removed all the tumor, we can get an mri.
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  And really that's another advantage.
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  And it'll be help us more to see if we've left any residual or any remaining
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  tumor that we can just go back in and get,
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  since there's already the exposure is done, we're already right there,
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  and we can utilize that to make sure that our patients have the best chance of
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  survival.
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  We can utilize the same technology for epilepsy surgery to make sure our
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  patients have the best chance of becoming seizure free.
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  And same form for brain tumors as well. So it makes our, uh,
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  intraoperative MRI suite,
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  the only one of its kind in North America is the fact that it h while it houses,
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  um, in a, in a setting where we can get intraoperative, get, um, uh,
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  outpatient MRI scans, it also is attached to two operating room suites.
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  And what makes it unique is that we can have three rooms going at the same time,
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  and one of the suites that has rails on the, on the ceiling,
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  and so the patient can roll into the MRI when it's time to get an intraoperative
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  mri and the other operating room, the MRI comes to the patient.
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  And so this is really a unique way to be able to utilize the footprint that we
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  have to have three rooms and two operating rooms going at the same time while
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  we're able to get diagnostic MRI scans and utilizing one MRI to, uh,
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  knock out three birds and one stone, if you will.
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  Nice. Thanks to so much for breaking that down, Dr. Kiri. Um,
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  so fa fascinating to hear about this new kind of cutting edge technology.
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  Wh when you think about the next big step for this neurosurgery program,
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  the next, in the next coming months, the next year,
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  are there any new technologies, anything else you're looking to implement to,
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  to improve patient care as well?
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  Well, absolutely. There, there's a lot of that, uh, exciting technology,
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  some of which we've already offer.
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  We're already offering our patients and coupling that with the interrupted MRI
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  suite really will, will take us to the next level and, and give, give us the,
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  give our patients, you know, the, the quite a bit more opportunity for,
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  for better outcomes, even though what we were getting before.
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  And one of those is using a robot, which we've been using, uh,
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  to implant stereotactic, uh,
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  electrodes deep into the brain to be able to study where their seizures are
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  coming from. Uh,
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  and then once we're able to study that so we can really map out where seizures
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  are coming from within a few millimeters. And once we're able to do that, um,
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  and let me go back and just say that we can do that without making a single
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  incision, which makes us really exciting.
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  It's minimally invasive for the patient,
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  then we monitor 'em afterwards and when they have seizures,
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  we know exactly where those are coming from.
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  And then we can meet as a group and go over where we think those seizures are
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  coming from with really good accuracy.
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  And then bring that patient to the intraoperative MRI suite,
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  remove that portion of the brain, uh, safely, uh,
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  that we think is causing the seizures, get an mri,
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  make sure we removed exactly what we have planned to remove,
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  and then that patient will have the best chance of, uh, of, of seizure freedom.
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  Uh, and so that, that's one. And then also we,
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  there's a laser technology laser inter interstitial thermo therapy,
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  which is a mouthful. So we just call it lit, uh, where we insert a fiber, uh,
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  laser fiber again with the robots. This is a robot into abnormal brain tissue,
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  whether it be a tumor or an area where that causes, um, seizures.
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  And we're able to, in real time in our intraoperative MRI suite,
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  heat that tissue up with our laser while making sure that we're not heating any
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  normal tissue and destroy that tissue.
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  And then we take that laser out and the patient's usually go home the next day.
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  So those are all really, uh, exciting piece of technology. And now with our new,
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  uh, intraoperative mri, the, the picture is quite a bit better than what's,
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  what's, you know, quote unquote the center of care too,
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  because with intraoperative MRIs or any kind of mri,
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  the size of the magnet really matters, uh,
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  as far as what kind of a quality of the picture.
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  And so usually 1.5 T is a center of care for magnet,
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  and ours is three T. So really the picture we,
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  we are getting with our new interrupter MRI is like, uh, you know,
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  looking at watching a football game on high def versus, uh,
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  an analog catheter ray tube. So it's really, uh, a beautiful thing.
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  Yeah, I appreciate the analogy there.
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  I break it down in layman's terms for people like me. Um, really,
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  really exciting. Thank you so much. Uh, I wanted to wrap up one last question.
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  I know Dr. Kire,
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  you've been medical direct medical director of the neurosurgery program at
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  Children's Minnesota, like you said, for the last year or so, uh, for,
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  for other emerging leaders stepping into similar medical director roles like
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  yourself, whether in an orthopedics, spine, neurosurgery program,
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  what are the keys to really building a,
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  a comprehensive multidisciplinary team within that specialty?
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  Is there anything that you'd recommend that they,
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  they kind of to kickstart that journey?
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  Well, I, I think, I think you, uh,
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  you mentioned that you hit the nail on the head.
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  You really have to treat a patient in a comprehensive fashion.
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  So you really have to collaborate, uh, with,
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  with other teams and other experts in your area and to make sure you've got the
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  right people. I think that's the first step. And then once you have that,
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  then you have to look at what you have as far as equipment to be able to offer
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  your patients the best care, uh, that you can as an institution.
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  And so a lot of, uh, a lot of healthcare systems, they have fantastic people,
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  but they're really siloed. So I think collaborative care, like in the,
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  in the care of patients with, uh, spinal cord tumors,
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  having a neuro oncologist and neuroradiologists, neuropathologists,
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  neurosurgeon, neurologists on board,
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  discussing each patient to be able to custom tailor, uh, you know,
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  their care and treatment plan for them and care. And in terms of epilepsy,
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  having a, uh, epilepsy center where you have epileptologist, neurosurgeon,
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  neuroradiologist, neuropsychologist, uh,
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  and people that really can discuss those patients and again,
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  be able to custom tailor the, their treatment plan and,
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  and come up with the best outcome. You, you couple that with, uh,
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  cutting technology and you really can offer patients the best care that you can.
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  Another key to success in building a successful program is that a lot of
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  healthcare systems in the United States are non-for-profits.
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  So Children's Minnesota is a non-for-profit hospital system.
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  And really to be able to have access to this technology and innovation,
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  all these costs, quite a bit of money,
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  money that a hospital and non-for-profit hospital doesn't have on its own.
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  And so another key to, uh, building a successful program,
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  I would say for emergence,
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  emerging leaders would be keeping a good line of communication open with your
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  board and also your community,
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  and let your community know what you're doing and, and,
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  and what grade work you're doing so that they can be engaged in your hospital
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  and in taking care of your patients. And,
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  and a lot of times communities are very generous and they're happy to donate if
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  they know that's going to good cause to, to, uh,
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  bring better outcomes for patients.
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  Nice. I think some excellent, uh,
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  advice for emerging leaders there to wrap up on. Uh, Dr. Kire, thank you so,
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  so much for, for taking the time to join the Becker podcast.
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  I have certainly learned a lot, a lot of exciting things certainly happening,
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  uh, within the neurosurgery program at Children's Minnesota. Uh,
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  look forward to connecting with you again down the line.
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  Thanks for the opportunity. Very nice talking to you.