Essential for surgical success: Teamwork


What does it take to remove a large tumor from the delicate nerves in the brain that animate the face and control hearing and balance?

Tremendous skill and rigorous training. But also: teamwork.

“We are a team in every sense of the word,” said Alejandro Rivas, M.D., one of the two surgeons who performed Vanderbilt patient Jordyn Spann’s 16-hour surgery. “We work very well together. Part of the success that we have with these surgeries is the way we understand each other and what we expect of each other.”

Traditionally, large tumors of the ear are removed by drilling into the bone behind the ear and performing the surgery with a microscope.

In Jordyn’s surgery, Rivas, an otologist and neurotologist, took the lead in getting access to the tumor, drilling the entire temporal bone and going in through the ear. Reid Thompson, M.D., a neurosurgeon, then came in to start resecting the tumor from the brain stem. The surgeons took turns operating until the resection was almost complete, working together around the facial nerve.

“Sometimes Dr. Thompson will be cheering for me when my hands are working and he’s looking on my side of the microscope, and sometimes I’m cheering for him, saying ‘that’s perfect, great move’,” Rivas said. “We’re a team.”

The team approach extends beyond the surgery, and Dr. Thompson said that is one of the factors that sets Vanderbilt’s program apart and creates more successful outcomes for patients. Their care requires multiple teams who all come together to make complex cases more routine.

“The more patients you see, the more time you spend thinking about these types of problems, the better your patients do. Their outcomes are better,” he said. “It’s one of the most gratifying things about being at Vanderbilt: Our team has an opportunity here to take care of a very large number of patients with somewhat uncommon brain tumors in complicated places, and we’ve developed a very unique experience in doing that.

“You develop a team of physicians, surgeons and nurses to take care of these patients and you also develop an appreciation for how every patient is different. You take care of these patients individually and meanwhile, you’re developing experience taking care of them. Patients do better when they’re cared for at a place like Vanderbilt.”