Parkinson's • A groundbreaking procedure in Rambam put the patient back on his feet

Tataina Sablina, 66, a resident of Acre, stands in front of the mirror in the Rambam hospital ward and arranges a handkerchief on her head. She goes to bed, takes her bag, leaves the room and says goodbye to the staff, before she goes home. "It's unbelievable."

Nurse in the ward:

It just seems like a miracle. Just a few days ago she was sitting in a wheelchair and needed help with almost every action. Look at her now. like nothing

This is the surgery that helped the Parkinson's patient to get up from the wheelchair • Watch

A groundbreaking procedure in Rambam

Behind this wonderful scenario is an innovative medical procedure that allows patients with movement problems to regain their quality of life, within a few hours, without an invasive operation on the brain. Sablina, a new immigrant from Russia, who lives with Parkinson's in an advanced state, recently became the first in Israel to undergo the procedure.

Several years ago, while still living in Russia, Sablina underwent a brain pacemaker implantation (DBS) - a well-known and well-known treatment to deal with Parkinson's disease, the operation led to complications, and nine months ago, after she had already moved to live in Israel, she arrived at Rambam, with a serious infection in the area of ​​the implantation .

The Rambam medical team treated the infection with antibiotics and other drugs, with the aim of stabilizing her condition and preserving the use of the pacemaker that Sablina was significantly dependent on. In Rambam, who treated her, "on the one hand the pacemaker endangers her health because of the infection, on the other hand she depends on him to perform operations. We knew that if we replaced the old pacemaker with a new one, we would have to repeat the procedure at some point, which could cause the patient a life-threatening chronic infection. In the absence of a response to the drug treatment, the options available to us were very limited."

With the best interests of the patient in front of their eyes, the medical team decided to go for an extreme solution - one that has not yet been implemented in the world: the pacemaker was removed from her brain for a period of several months in order to allow the area to recover and take control of the infectious process. At this stage, due to Sablina's great dependence on the device removed from her brain and despite many attempts to balance through combined drug therapy, she became a nurse and moved to live in assisted living. Since her condition allowed the continuation of the treatment, Sablina returned to the Rambam to perform a FUS procedure - burning by focused ultrasound waves under MRI monitoring. Burning in five different centers in the patient's brain, to control the symptoms of Parkinson's disease: stiffness, slowness and tremors together. After the operation, there was a huge improvement in the patient's condition, and she walks and performs various actions successfully, without any assistance.

"Barambam dared to do something they had not done before"

Dr. Ilana Schlesinger, director of the Institute for Movement Disorders and Parkinson's and a senior physician in the Department of Neurology at Rambam:

Today, patients with advanced Parkinson's disease undergo invasive brain surgery, but the process can have severe complications, as we saw in this case. Now we offer a treatment that not only reduces tremors, but treats all the symptoms of Parkinson's disease, in a non-invasive way. No drilling in the skull. There is no risk of bleeding. There is no chance of contamination. Instead of an operation lasting many hours, it is an operation that takes between one and two hours. We are witnessing a transformation in the treatment of Parkinson's. This is great news for patients in Israel and around the world.

Dr. Lev Tov acquired this skill while undergoing an internship in the neurosurgery department at Stanford for several years. "The technology that exists today allows us to think of solutions outside the box for patients who in the past had to live with a poor quality of life," says Dr. Lev Tov, "It is in a ground-breaking procedure, which is performed in a very limited number of centers in the world. Tataina also became the first ever Parkinson's patient in the world to undergo a FUS burn procedure after she had already had a pacemaker implanted. To see her go from a state of enormous difficulty in functioning, to a state where she is Almost normally, it's an exciting turning point. It's the moment when you realize the power we have to change people's lives."

According to Sablina, she did not believe for a moment that this is how the process would end: "I am so happy", she says succinctly a few days after undergoing the procedure, "There is nothing to compare between what was before and now, and this is only the beginning", she promises with a smile.

Brain surgery without a knife: the sky is the limit • This is a non-invasive, MRI-guided procedure

The treatment of primary tremor or parkinsonian tremor with the help of ultrasound (FUS), was developed in Israel several years ago by an Israeli start-up company called "Insitec". The treatment for primary tremor was introduced to Rambam through the medicine basket in 2013.

This is a non-invasive, MRI-guided procedure, which uses advanced technology - a helmet with more than a thousand ultrasound transmitters for the purpose of burning certain areas of the brain, without drilling or opening the skull, and without the use of a surgeon's knife, in order to treat tremors. At the end of the treatment, which lasts several hours, a significant improvement was observed until the tremor immediately disappeared. Rambam is considered the leading center in treatment in the world, with high success rates. Rambam was recently chosen to be the first center in the world to lead the new generation of the FUS device (EXABLATE PRIME), which is a significant springboard in the quality and safety of treatment.

Now, with the treatment of Sablina, the treatment using the FUS, has gone up a step and makes it possible to examine the treatment of new diseases and conditions in which it was not performed before. Rambam and Insightek have been collaborating for over a decade in the development of technology, with the medical center serving as a research and treatment base in the field of FUS, one of the leaders in the world.