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Doctors from Former Soviet States Learn New Brain Surgery Techniques in Israel

Non-invasive endovascular neurosurgery techniques are being taught in Tel Aviv to young Russian-speaking doctors from former USSR states.

Dozens of doctors from Kazakhstan, Georgia, Russia and other republics of the former Soviet Union have packed themselves into a room on the 12th floor of Tel Aviv’s Ichilov hospital. They gaze intently at two huge plasma TV screens. Some take notes, others point and whisper comments to their colleagues. 

On screen is a pair of world renowned interventional neurosurgeons performing brain surgery on a 26-year-old woman. It is a complicated procedure since it is being done without ever having to touch the skull.

“What we are dealing with is a very difficult and a new type of medical procedure,” says Dr. Alex Berenstein, a pioneering interventional neurologist based in New York. “We want to excite them about it.”

Berenstein has teamed up with his Israeli colleague, endovascular neurosurgeon Prof. Shimon Maimon to hold a training conference in Tel Aviv for the Russian-speaking doctors to help spread this new, less-invasive medical technique.

According to the World Health Organization strokes and other cerebral hemorrhaging incidents are the leading cause of death in middle incomes worldwide. Doctors in Israel, France, Turkey and the United States have been perfecting delicate endovascular neurosurgery procedures for the past decade but these procedures are only now reaching the rest of the world.

“We started to do lots of cases during the last year and a half,” says Dr. Yerbol Makhambetov, a senior neurosurgeon from Kazakhstan. “We can do simple cases ourselves and if it is a difficult case we can cooperate with Dr. Maimon and perform operations together.”

Because of licensing restrictions in the United States and because of the plethora of Russian-language expertise and top-notch hospitals in Israel, it was decided to bring 120 doctors from member states of the former Soviet Union to Tel Aviv. They’ve come not only to hear about the latest technologies but to see it performed first hand.

“I can give you 25 hours of lectures,” says the energetic Berenstein. “But one word cannot match a picture or actually see a real life demonstration.”

After two days of lectures the doctors gather in Ichilov hospital to watch and learn. In the operating room on the ground floor is a young woman who suffers from a birth defect which could cause a fatal stroke. On the screen is a radiological ‘road map’ of the brain’s major arteries. Every word spoken by the doctors is translated into Russian. 

“What we are going to try doing is to go and navigate without opening the head,” Berenstein says. “We will go from the blood vessel of the leg, one of the branches of the tree, into the main trunk of the tree, the aorta, into the blood vessels of the brain and then liquid material which is like silly putty, will be injected very slowly and will harden to create a cast of this bizarre amorphous piece of anatomy.”

Prof. Maimon pushes the guidewire from the femoral artery in the leg, deep inside the young woman’s brain. He is hunting for an Arterio-Venous Malformation, or AVM. This ‘short circuit’ of the brain could rupture and cause cerebral hemorrhaging. Once they find it, the doctors inject a newly-developed, non-adhesive, silly-putty-like glue called Onyx to seal the vessel.

Dr. Sergey Pashnin, a neurosurgeon from Cholybinsk in the Urals, is clearly impressed.

“We learned a lot and we find this meeting very useful,” Pashnin says. “We will come back to Russia more educated.”

Berenstein says there are Russian doctors who are also very experienced in the new endovascular techniques, but the conference in Israel was aimed at reaching doctors from areas outside the main cities.

The plan is for Berenstein and other experts to follow up the conference with a series of training courses and master classes in the various former Soviet republics.

“Now we can give our colleagues in Kazakhstan basic knowledge of endovascular procedures,” says Dr. Makhambetov.

Dr. Vladimir Zelman, a Russian-born neurologist who now lives in Los Angeles, believes Israel was the natural place for such a conference since it had many Russian-speaking immigrants and a high level of medicine.

“Here today were presentations on how we can provide better care for less money,” Zelman says. “Russia and Israel have started to become much closer.”

He notes that today’s young doctors in the former Soviet republics don’t necessarily suffer from the institutionalized anti-Semitism rampant during the Communist era.

“This young generation is absolutely not politicized. …These young people who came here will be big ambassadors and they will tell everybody in Russia that Israel is a beautiful country, very friendly, even that it is like a model of a modern society.”

Perhaps, but for Dr. Berenstein his aim is not just to promote friendship, but to ultimately improve health care with a cheaper, closed surgery technique with lower risk factors.

“Physicians are people who are very passionate about what they do,” Berenstein says. “There is no better way than to see how you cure somebody in front of your eyes. Then you may have the ability to translate that and cure other patients.”