Torrance Memorial physicians are experts in advanced technologies to improve
care and speed recovery.
Written by John Ferrari
What is it? “It’s like a GPS for the brain,” says Paula Eboli, MD,
Torrance Memorial’s medical director of endovascular neurosurgery.
What does it do? Brainlab imaging equipment and software “enables you to do complex
neurosurgery. Brainlab interacts with the microscope we use and tells
you exactly where you are operating. As you operate to remove a brain
tumor, you can overlay the tumor’s contours on your microscope.”
The system also incorporates digital ultrasound. “You can make an
ultrasound image of the area, and Brainlab will fuse that image with MRI
images,” Dr. Eboli says.
Why is that important? “Knowing exactly where the tumor is helps with resection [removal]
of the tumor.”
How does it improve on previous technology? Torrance Memorial’s Brainlab suite adds new imaging capabilities,
allowing neurosurgeons to see the area of the brain they’re operating
on with unparalleled precision.
Who is a good candidate for this technology? “I use it for every single brain tumor patient.”
What’s the bottom line? “You want to have the best technology in order to ensure complete
brain tumor removal with the least amount of damage.”
What is it? Extracorporeal Membrane Oxygenation is an emergency life support machine.
What does it do? “ECMO takes blood from the body, removes carbon dioxide, adds oxygen,
then pumps it back into the body,” explains Aziz Ghaly, MD, medical
director of cardiac surgery at Torrance Memorial’s Lundquist Lurie
Cardiovascular Institute. “It’s used on patients who have
serious heart and lung injuries.”
Why is that important? “It gives the patient’s heart and lungs time to rest and heal.
For example, we’ve used it on extremely ill COVD-19 patients whose
lungs were compromised by the disease. It’s also an extremely important
addition to the hospital in general.It allows us to perform more complex
How does it improve on previous technology? “ECMO is used in emergency situations to support the functions of
the heart and the lung together. It can be applied very quickly on patients
who have no other option to survive. ECMO is a rarity outside major academic
medical centers. Torrance Memorial has several ECMO machines and can use
them to support up to five patients.”
Who is a good candidate for ECMO? “Patients who have a failing heart after a cardiac arrest or who
fail to recover after open-heart surgery,” Dr. Ghaly says. “We
also use ECMO for lung conditions like severe lung disease not responding
to traditional measures and on patients awaiting heart or lung transplants.”
What’s the bottom line? “ECMO is a lifesaving device. It’s not a treatment.It’s
a support device that can substantially improve a critically ill patient’s
chance of recovery. It gives patients more time.”
What is it? MarginProbe is a device that uses electromagnetic waves to identify potentially
cancerous tissue during a lumpectomy procedure for breast cancer.
What does it do? “MarginProbe uses radio frequency electrical fields to evaluate tissue
that has been removed during a lumpectomy procedure in order to identify
any cancer that may be remaining on the surface of the tissue,”
explains Melanie Friedlander, MD, surgeon and co-director of the breast
cancer program at the Torrance Memorial Hunt Cancer Institute. “If
MarginProbe identifies cancer on the surface of the tissue, the surgeon
will remove additional tissue from the breast.”
Why is that important? “The edges of a lumpectomy cannot be analyzed by a pathologist during
surgery, so this is the best technology available to help the surgeon
get all the cancer out at the initial surgery, eliminating the need for
a second procedure to take a little more tissue.”
How does it improve on previous technology? “Before we had MarginProbe, there really was no way to check the
margins other than a visual estimate by the pathologist, which is done
with solid tumors but cannot be done with DCIS, a microscopic type of
cancer,” says Dr. Friedlander.
Who is a good candidate for this technology? “MarginProbe can be used for lumpectomy for all types of breast
cancers, including invasive ductal carcinoma, invasive lobular carcinoma
and ductal carcinoma in situ (DCIS).”
What’s the bottom line? It’s totally safe and can reduce the need for additional surgery.
What is it? A robotic system that assists in partial and total knee replacement and
total hip replacement surgery.
What does it do? Mako allows surgeons to operate with unparalleled accuracy and precision.
“Using a detailed 3D image of the joint, the Mako system allows
more accurate assessment of soft tissues, more accurate preparation of
the patient’s bone for the implant and more accurate placement of
the implants,” says orthopedic surgeon John Tiberi, MD, a hip and
knee replacement specialist.
Why is that important? “There are clear correlations between good outcomes and optimal
implant position,” says Dr. Tiberi. “Also, proper ‘balancing,’
or tensioning, of the joint’s soft tissues and appropriate leg length
restoration are important for a good outcome.”
How is it better than previous procedures? Using the Mako system, “the surgeon has the ability to plan the
procedure based on the patient’s 3D anatomy, and the measurement
calibration is very accurate,” explains Dr. Tiberi. “With
manual technique, the information is quite limited because it is based
on a 2D X-ray, and the measurement calibration is almost always inaccurate.”
Who needs it? The Mako system is appropriate for any patient undergoing partial knee,
total knee or total hip replacement.
What’s the bottom line? Better outcomes after surgery and less post-operative pain.
Da Vinci XI
What is it? A robotic system that assists surgeons performing minimally-invasive surgery.
What does it do? “The da Vinci system allows for conversion of advanced open surgery
to minimally-invasive laparoscopic surgery,” says gynecologic oncologist
Ramin Mirhashemi, MD. The system comprises a suite of instruments the
surgeon guides via a console, and imaging tools that provide magnified,
3D, high-definition views of the surgical area. The instrument size makes
it possible for surgeons to operate through small incisions.
Why is that important? “Reducing the incision size and trauma to tissue results in more
rapid recovery and shorter hospital stays,” Dr. Mirhashemi says.
This means more surgeries can be performed on an outpatient basis.
How is it better than previous procedures? “It’s more precise and spares normal tissue while we dissect
pathologic tissue. And the 3D visualization is significantly better than
our eyes alone.”
Who needs it? “Any patient who is being considered for open surgery can be a candidate
for robot-assisted surgery.” The da Vinci system may be used for
general, cardiac, colorectal, gynecologic, urologic, head and neck and
What’s the bottom line? “Less pain and faster recovery with better overall outcomes!”
says Dr. Mirhashemi.
What is it? A way to selectively kill cancer cells by using a photosensitizing agent
What does it do? Photodynamic therapy (PDT) begins with the photosensitizing agent entering
the bloodstream or applied to the skin, where it is absorbed by the body’s
tissues. The agent remains in cancer cells longer than in normal cells.
When most of the agent has left healthy cells but is still in cancer cells,
it is activated with light—an LED or a laser—causing a chemical
reaction that kills the cancer cells.
Why is that important? “The normal cells right next to the cancer cells are left uninjured,”
explains Clark Fuller, MD, surgical director of thoracic oncology at Torrance
Memorial's Hunt Cancer Institute. “It’s a highly selective
form of therapy that allows surgeons to specifically target cancer cells.”
How is it better than previous procedures? Many other forms of cancer treatment are less targeted, more invasive and
may result in harmful, long-term side effects. “And,” says
Dr. Fuller, “a single injection allows us to treat the patient as
many times as needed… until we have the desired effect.”
Who needs it? “PDT can be used to treat cancers causing obstructions of the esophagus
and the airways that can be reached with only an endoscopy.”
What’s the bottom line? “It’s more non-invasive than surgery and may be done on an
outpatient basis treating tumors that may otherwise not have a successful
What is it? SpaceOAR (Spacing Organs At Risk) is a temporary gel placed between the
prostate and rectum prior to radiation treatment for prostate cancer,”
explains Torrance Memorial Hunt Cancer Institute radiation oncologist
Usama Mahmood, MD.
What does it do? “SpaceOAR helps physically separate the prostate from the rectum
so when radiation is used to treat prostate cancer, there is less unnecessary
radiation exposure to the nearby rectum.”
Why is that important? “By decreasing the amount of unnecessary radiation exposure, SpaceOAR
has been shown to decrease both short- and long-term side effects of radiation
treatment for prostate cancer.”
How does it improve on previous technology? Although radiation treatment for prostate cancer is safe, this makes it
Who is a good candidate for this technology? “Patients with early-stage prostate cancer who have not undergone
surgery and are to receive radiation treatment.”
What’s the bottom line? Dr. Mahmood puts it succinctly: “Less radiation exposure, less side