Advanced Minimally Invasive Surgery Saves a Patient’s Sight

Lindsay Warfield of Colchester used to lie awake at night wondering what to do about the pituitary tumor growing in her head, pushing on her optic nerve and slowly reducing her ability to see.

“It was pretty scary,” she said. “I didn’t want to lose my independence, my ability to drive, to read. I know that people can live happy lives with loss of vision, but the thought of not being able to watch my kids grow up was pretty horrifying.”

During those late-night hours, Warfield began researching doctors, hospitals and surgeons. A previous attempt at removing the tumor by a surgeon in Florida, where she used to live, had failed, and memories of that experience only made it harder to pick a doctor and schedule an appointment.

“But, fear of losing my vision prompted me to make an appointment, and I’d done my research,” Warfield said.

Preparing for minimally invasive surgery

She chose Jacky Yeung, MD, a neurosurgeon with L+M Hospital, assistant professor of Neurosurgery with the Yale School of Medicine, and a specialist in minimally invasive neurosurgical procedures.

“I could see that Lindsay was actively going blind because of this tumor,” Dr. Yeung said.

Dr. Yeung consulted with Frank Dellacono, MD, chief of Ear, Nose and Throat Surgery at L+M Hospital, and they decided to collaborate on Warfield’s case.

Warfield felt she had made the right choice. “I was incredibly surprised by how quickly they got me in for appointments, for MRIs; and then they assembled the whole team,” she said. “I first saw Dr. Yeung in December and I was in for surgery by the first of February.”

“We worked in unison,” Dr. Dellacono said. “We worked endoscopically through the nose to the skull base. I opened the skull base, and then Dr. Yeung came in and opened the deeper part of the skull base to remove the pituitary tumor.”

As they operated inside Warfield’s head, both doctors used state-of-the-art imaging guidance available at L+M Hospital. “There’s a small camera on a rod which goes through the nose into the skull base,” Dr. Dellacono explained. “We watch on a large screen roughly the size of a flat screen TV. Superimposed on the screen we have a navigation system showing both CT scans and MRIs and it shows us precisely where we’re going, like GPS in a car, so we can move safely around delicate structures such as the eyes, the optic nerve, the internal carotid artery inside the skull base. We’re always trying to keep those areas safe.”

Without a single visual scar, Dr. Yeung removed the tumor. “When I have a good colleague like Dr. Dellacono, we can work in partnership to be minimally invasive but maximally effective in taking out tumors like this,” Dr. Yeung said.

On the second day after surgery, Lindsay was essentially pain free, the tumor was gone, and she was on her way home.

“I’m so grateful,” Warfield said. “Both doctors were so personable. It wasn’t like I was just the next patient. They were very caring. They took everything I said very seriously. I also liked the way they worked as a team. I felt like I was in really capable hands.”

Both doctors praised the support they received from nurses, techs and staff in the L+M Operating Room. “A case like this is never just about one or two surgeons,” Dr. Yeung said. “It takes a village to carry out a successful surgery like this and we owe our gratitude to the OR team at L+M.”

Dr. Yeung said cases like Warfield’s are rewarding not only for the skill and technologies brought to bear, but also the human element. “The thought of surgery brings a lot of psychological stress for patients like Lindsay,” he said. “We’re not just treating what we see on MRIs or X-Rays. We’re striving to improve someone’s life.”