Neurosurgeon Kia Shahlaie has extensive training in minimally invasive neurosurgery, which allows him to avoid the more invasive procedures and longer recoveries typical of other Northern California neurosurgery programs. Shahlaie can pass a camera and specialized surgical instruments to the back of the nasal passage and directly to various regions of the skull base, without scarring and with a shorter recovery.

Q: At what stage of development was minimally invasive brain surgery when you first were exposed to it?

A: Minimally invasive brain surgery was in its early stages when I was a resident at UC Davis Medical Center. We were starting to perform some operations through smaller, more targeted approaches, but the majority of the brain surgery procedures I learned during residency were through traditional approaches. I had one key mentor as a resident, Dr. Jim Boggan, who was among the early pioneers who performed brain surgery using endoscopes, lasers and other tools that allowed for small surgical approaches. After completing my residency, I pursued fellowship training at one of only a handful of centers in the world that was developing new and innovative minimally invasive brain surgery techniques.

Q: What were your initial impressions of it?

A: I thought these operations were amazing, technically very elegant and just a “smarter” way to achieve the same goals of traditional surgery. Most importantly, patients recovered so much better from these minimally invasive operations!

I was also struck by the technical challenge of performing safe minimally invasive brain surgery! Operating through smaller openings is at first very difficult, and special equipment and an advanced understanding of brain anatomy is absolutely critical.

Q: How have you been affected by the difference minimally invasive brain surgery has on your patients?

A: The patient experience is dramatically better with minimally invasive techniques when they are applicable. With the help of a surgical navigation system that is essentially “GPS for the brain,” we can access the brain through small incisions in the scalp that we can easily hide with little to no hair shaving. Some operations can be performed through small “keyhole” openings in the skull, with incisions that are hidden behind the ear or even within the eyebrow. In many cases, we can perform brain surgery with no external incisions at all, by passing a high-definition endoscopic camera through the nose and sinuses to access the brain from below.

What this means for our patients is shorter hospital stays, less pain and discomfort after surgery, better cosmetic outcomes, and a quicker return to an active lifestyle. The benefits are dramatic, and the “brain surgery experience” is so much better than with older techniques.

Q: What do you see as the potential for expanded use of minimally invasive brain surgery?

A: I think minimally invasive brain surgery will continue to expand, and eventually will become “the way” we do most brain operations. We saw this evolution in other surgical specialties decades ago, and I believe neurosurgery is undergoing a similar evolution. I am so glad that we are seeing more emphasis on our patients’ experiences during surgery. There is more focus on reducing pain, performing an operation with little or no scarring, and helping our patients to return to their normal lifestyles more quickly. I think these are critical factors that will drive all neurosurgeons to offer their patients minimally invasive treatment options.

Q: As a Sacramento native and graduate of both UC Davis and the UC Davis School of Medicine, what does it mean to you to be a member of the SOM faculty?

A: It is extremely meaningful to me! After completing my fellowship training in 2010, I was excited to return to UC Davis to help establish and advance a new program in minimally invasive neurosurgery. Returning to my hometown of Sacramento, and to my alma mater UC Davis, was very important to me. I feel very strongly that people in our region should have access to leading-edge brain surgery, and our medical students and neurosurgery residents should be exposed to advanced minimally invasive techniques. As a member of the UC Davis faculty, I am committed to training the next generation of young neurosurgeons and I am very proud that most of our graduating neurosurgery residents have gone on to perform fellowship training in minimally invasive neurosurgery.

The School of Medicine and the medical center provide care to a very large area of Northern California – it means a lot to me that we are now on the forefront of minimally invasive brain surgery and are able to offer our students, residents and patients access to this leading-edge neurosurgical care.