Hani Marcus
@hani_marcus
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Consultant Neurosurgeon | @QSNeurosurgery Honorary Associate Professor | @BRAIN_UCL @UCLIoN Deputy Director | @WEISS_UCL Lead for Neurosurgery | @NIHRCRN_ntham
London, United Kingdom
Joined June 2012
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Now available from all good bookstores - thanks again to all the contributors!
#neurosurgery
#robotics
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A great pleasure to be at the
#SBNSDUNDEE2021
and (finally) deliver my Hunterian Oration! Thanks again to all mentors, colleagues and students for the support.
#neurosurgery
#research
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18
300
Very excited to soon be seeing in print the first book dedicated to Neurosurgical Robotics - covering both engineering principles and the clinical applications - thank you to all the contributors!
#neurosurgery
#robotics
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37
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Congrats to my 3 outstanding clinical research fellows,
@JohnHanrahan1
,
@SimonWNeuro
, and
@jon_funnell
- for the second year running, all have secured a neurosurgical training post, and we’ve been lucky enough to keep them all in London too!
#proud
#Neurosurgery
👏 👏 👏
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Why do surgeons operate on the wrong side or leave a swab behind? The answer, in large part, is
#inattentionblindness
- missing obvious things hiding in plain sight. Why does this happen and how can we stop it? Let’s found out… 1/6
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The meninges consist of the dura, arachnoid, and pia mater, right? Think again!
More textbook changing work on the glymphatic system, now reporting a 4th layer that divides the subarachnoid space.
#neuroscience
#glymphatics
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Our newest academic trainee,
@dzkhan94
performing a simulated endoscopic pituitary adenoma excision (and doing a very good job too I might add!) The pump, which
@EmDimitrakakis
developed, should allow for bleeding should the carotid be injured…
#simulation
#pituitary
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Can
#AI
write papers? My research fellows reckon it can do at least as good a job as me. To be fair this is a pretty good attempt, right down to the Oxford commas…
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Excited to welcome
@WRMuirhead
to
@QSNeurosurgery
. Special for me as he was my first clinical research fellow from our trainee days. Now a consultant with a 50/50 focus on lateral base surgery & neurotechnology. Exceptional surgeon, strong academic, and all-around great guy.
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Just in time for Christmas, we have been awarded a new
@EPSRC
grant to combine
#AugmentedReality
and
#ArtificialIntelligence
to help surgeons perform endoscopic pituitary surgery. The funding covers salary for several post-docs, so get in touch if keen!
I'm pleased to announce a new
@EPSRC
funded grant to improve patient care in endonasal surgery using AI and AR.
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First day of inaugural MRes Neurosurgery
@UCLIoN
- the first such MRes in the UK aimed at developing the next gen of academic neurosurgeons. Full credit to
@drmohdkamel
for doing a brilliant job organising.
#neurosurgery
#research
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9
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New surgical devices often drive advances in care. After all, without moderns drills we would still be using stones to operate on the head! But how do these devices emerge, and when is best to first actually use them in patients? Let's think about innovation in this
#tweetorial
.
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1/4 As trainees rotate, I’ve been reflecting that this will be the first time since 2020 we be without
@dzkhan94
&
@hugo_lh
, who joined us
@QSNeurosurgery
as the inaugural 50/50 Weiss Fellows. We have been *incredibly* lucky to have had them in our team.
#neurosurgery
#research
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Grateful to
@RCSnews
for being awarded a Hunterian Lectureship on the application of robotics to endoscopic brain surgery, and many thanks to
@ICLHamlynRobots
,
@Health_Eng
, and
@wellcometrust
for supporting my research.
#pituitary
#neurosurgery
#Robotics
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Looking for an F3 job? Interested in
#neurosurgery
&
#research
? The new
@WEISS_UCL
&
@TheCrick
50/50 clinical research fellowships at
@QSNeurosurgery
are out - . The only drawback is you’ll have to measure up to the top tier current/previous fellows!
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🧠💻🤖 Join our growing research team and develop cutting-edge neurosurgical technologies! As a Clinical Research Fellow, you'll lead projects in BCI (
@TheCrick
), AI/robotics (
@WEISS_UCL
), & simulation (
@QS_SimCentre
), while upskilling in neurosurgery.
1/4
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*** CLINICAL RESEARCH FELLOWSHIPS ***
We are pleased to announce 2 clinical research fellowships (50/50) with
@QSNeurosurgery
and
@WEISS_UCL
. For more information see below, contact me, or contact the (excellent) current fellows
@dzkhan94
and
@Hugo_LH
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Well done
@SimonWNeuro
- 1st paper, 1st author, and 1st off the mark amongst the current
@WEISS_UCL
and
@QSNeurosurgery
fellows too 😉 Artificial Intelligence in Brain Tumour Surgery—An Emerging Paradigm
#mdpicancers
via
@Cancers_MDPI
#neurosurgery
#ai
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1/3 🧵Wondering the future of
#PituitarySurgery
might look like?
@dzkhan94
and
@JohnHanrahan1
's review in Endocrine Reviews paints an exciting picture.
#HealthTech
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Calling all neurosurgeons around the world - if you have not already done so, pls do sign up to
@CovidSurg
- a chance to capture the impact of COVID on our practice (and particularly brain tumour surgery).
#COVID19
#surgery
#neurosurgery
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After many years of following the US Match, we now have “skin in the game”, with
@QSNeurosurgery
having a very successful exchange programme with
@ColumbiaNeuro
(and have always been impressed by their stellar residents!)
We look forward to having
@NathanShlobin
,
@ColinSperring
,
Congratulations to our 2024 Matches!!! Welcome to the Columbia Neurosurgery family!
#Match2024
#MatchDay
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🌟 Exciting Opportunities
@QSNeurosurgery
🌟
Happy to announce the next round of Clinical Research Fellowships [] and Medical Student Internships [] at our Surgical Technology group at Queen Square in collaboration with
@WEISS_UCL
and
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Never overly convinced by these sorts of reports, but always nice to see
@QSNeurosurgery
ranked well (albeit pipped to the post by
@TedSchwartz13
and the
@WCMCBrainSpine
!)
#neurosurgery
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Congrats all!
To those who didn’t, remember:
1. If you aim high enough, you’re going to be rejected from time to time.
2. The process isn't perfect, so don't be too hard on yourself.
3. Growth comes from failures, whether as a JCF, doing research, or choosing something else.
Congrats to all at
@QSNeurosurgery
who got a neurosurgical training post, particularly our 2 clinical research fellows,
@Sidsinha92
,
@James_Booker_
, and our inaugural MRes neurosurgery student,
@Tomiwaolukoya
, who ranked highly and stay in London with us! 👏
#neurosurgery
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Huge thanks to the trainees that nominated me for the
@ASiTofficial
#SilverSuture
award for best trainee trainer, and congrats to
@richbamford81
- a worthy winner!
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Indeed, and double congratulations to all those also within our research group who secured a training post in London this year, and whom we are lucky enough to keep. I know how hard you have all worked, and am very proud of your success!
- Dr Newall (
@newall_nicola
): previous
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This reminds me a memorable exchange I had with Christian Ulbricht when I was his trainee
@neuro_at_ic
…
#neurosurgery
#CSDH
#buttholes
Can rectal evacuation really be as good as twist drill for cSDHs?
Amazing what surgeons can do these days🤯😅
#innovation
#neuronightsofknowledge
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Proud to have lead the work on evaluating
#surgical
#robotics
with
@IDEALCollab
, as published in
@NatureMedicine
. It's been a labour of love, and huge thanks go to my (>80!) authors & collaborators.
#NoInnovationWithoutEvaluation
Surgical robotics are amongst the most complex devices entering healthcare - but how should we evaluate them? Published in Nature Medicine the IDEAL Robotics Colloquium outlines the latest guidance to aid researchers evaluating surgical robots: (1/9)
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Warm welcome to those joining us at the
@QSReview
course today, and huge thanks again to our session leads, all those that have done all the hard work setting up!
#Neurosurgery
#QSNS21
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Thank you for visiting us, Secretary of State
@michelledonelan
, and for supporting this project
@UKRI_News
- the funding will allow us to further develop our technology to apply AI during surgery and ultimately help patients with pituitary disease and other brain tumours.
Fascinating visit to
@WEISS_UCL
where AI is being employed to boost the precision of medical instruments and reduce complications in surgery.
Looking ahead to an exciting future when this technology can be rolled out to patients across the NHS and improve healthcare outcomes.
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Warm welcome to our new trainees to
@QSNeurosurgery
, and particularly to our newest
@WEISS_UCL
clinical research fellows:
@JohnHanrahan1
,
@SimonWNeuro
, and
@Jon_funnell
. The last cohort were exceptional, and your goal should be to do even better!
#neurosurgery
#NewDoctors
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Comparison of robotic and manual implantation of intracerebral electrodes: a single-centre, single-blinded, randomised controlled trial - well done
@VejayVakharia
for leading this study at
@QSNeurosurgery
👏 👏 👏
#neurosurgery
#robotics
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Very proud of work by
@EmDimitrakakis
on a new design a 3.6mm diameter, three degrees-of-freedom, tendon-driven robotic end-effector - perfect for wrist-like dexterity in
#endoscopic
#neurosurgery
! Thank you again to
@BrainAppeal
for supporting this work.
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*** ATTENTION TRAINEES ***
We have just advertised for a new job - it is part time (50%) and designed to support those wanting to do e.g. an MSc at the same time.
The rota means you work 1 week in 3. Opportunities for locum shifts too, if you wish.
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A nice collaborative review between
@QSNeurosurgery
and
@ImperialSandC
on “Simulation in Neurosurgery” just published:
TLDR: simulation is increasingly used, but not yet widely accepted within the community...
#neurosurgery
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*** ATTENTION TRAINEES ***
The
@QSNeurosurgery
Pituitary Fellowship starting Aug '22 just advertised. Great opportunity for those interested in pituitary surgery, and excellent preparation for consultant practice (which I can vouch for personally!)
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Excited to be the new pituitary fellow at the National Hospital from Aug
#pituitary
#neurosurgery
#endoscopy
@QSNeurosurgery
@DrBaldeweg
@UCLHEndo
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Huge thanks to all the delegates, fantastic faculty & most importantly to our organisers who worked *tirelessly* but made it look easy.
Special thanks to
@SaniyaMediratta
&
@SoghaKh
for vivas;
@dzkhan94
,
@hugo_lh
, and
@TalhahChaudri
for IT; and
@aida_kafai
for making it happen!
With the course coming to an end, we had spectacular talks from course co-lead Mr
@SayalParag
, Mr
@pratipalkalsi
and Mr B Thakur!
Exited for Mr G Prezerakos to round off the day!
#spine
#spinalneurosurgery
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Hi peeps, today’s
@ebrainnet
sessions is at 18:00 on “innovation in neurosurgery”. Details on joining sent out via the
@e1v1m1
email list. If you didn't get them DM me or
@neerajnkalra
.
#neurosurgery
#innovation
#robotics
#AI
@WEISS_UCL
@QSNeurosurgery
@IDEALCollab
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14
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*** Attention all trainees ***
We've just advertised for the next pituitary fellow job
@QSNeurosurgery
. The positives - great team, great unit, and great cases. The negatives -
@ag_kolias
has set the bar *very* high.
0
15
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In a new study by
@anandpandit00
#mindfulness
- really a tool to increase the cognitive bandwidth - seems to reduce inattention blindness. More work needs to be done, but this is a really encouraging finding! Huge thx to
@BrainAppeal
for support. 6/6
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Calling all neurosurgeons: very useful paper for day to day practice👇, confirming lots of functional disease in our “scan-negative” CES pts, and pragmatic ways to help identify. I have long felt that these pts would be helped by being plugged into neurology clinics
@tompollak
...
“Scan-negative” cauda equina syndrome: A prospective cohort study | Neurology.
@IngridHoeritza1
phd study out today. There are a lot of take home messages on CES. PR a waste of time but do check those ankle jerks- much more inside.
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8
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Really nice little bit of work by our previous pituitary fellow Ivan Cabrilo, showing the use of the
@Medtronic
electromagnetic flat emitter, to allow for easier Axiem-guided placement of catheters on ITU - - now if only we could guide the drill itself? 🤔
1
9
36
Brilliant work, expertly led by
@EdlmannE
,
@ag_kolias
, and
@pja_hutch
. Throwback to 2009, when I was an ST1, and we first conceived the idea - which shows just how long these things take!
#neurosurgery
#EBM
⚠️ Results from the
@BNTRC
@The_SBNS
Dex-CSDH randomised trial now published
@NEJM
"Trial of
#dexamethasone
for chronic
#subdural
haematoma" 👉
#neurosurgery
#neurology
#geriatrics
#research
Press release 👇
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Wish I had this during my training!
Thrilled to launch 10,000+ flashcards for neurosurgery residents & med students based on the iconic Greenberg’s Handbook of Neurosurgery! 😷🔪🧠
We
@SynaptiqHQ
are so honored to make this a reality with
@ThiemeIntl
& Dr. Greenberg himself 🙏
Try it here:
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4
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Huge congrats to
@EmDimitrakakis
for coming 2nd place at this year's
@eu_Robotics
forum. Very excited to soon see these being used to help treat patients with pituitary and related disease.
As always, extremely grateful to the
@BrainAppeal
#InnovationFund
for their support!
0
5
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Fascinating article in the
@NEJM
- the act of forgetting may be an *active* process with microglia and complement targeting neuronal synapses that store a memory tagged for removal.
#neuroscience
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Top athletes obsess over their performances through detailed analytics. Should top surgeons be doing the same?
@dzkhan94
explains our work
@WEISS_UCL
here in a collaborative video with
@PDoT_art
:
#surgery
#data
0
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Thank you
@MartinStewITV
and
@EmilyPringlee
from
@ITVnews
for sharing our
@IDEALCollab
work on evaluating
#surgical
#robotics
-
Thanks too for giving
@WEISS_UCL
the chance to share the new robots we're building (and shout out to
@BrainAppeal
for funding
Would you be happy to be operated on by a surgical robot controlled by AI? ITV News'
@MartinStewITV
and
@emilypringlee
reports
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Brilliant
@PituitarySoc
congress so far. Also a real pleasure to finally meet people face to face again.
Thank you to the organisers,
@MariaFleseriu
and
@giustina_andrea
!
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Huge thanks again to the
@BrainAppeal
for providing funding for us to develop a high fidelity model to simulate pituitary and anterior skull base surgery at
@WEISS_UCL
@QSNeurosurgery
- will be v helpful for both training and research!
#pituitary
#robotics
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@BrainAppeal
Many thanks
@BrainAppeal
for supporting our collaborative research
@QSNeurosurgery
@WEISS_UCL
#pituitary
#robotics
- though I have to confess I always wince at the sight of myself in videos!
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DECIDE-AI: fantastic new reporting guideline for early-stage, live clinical evaluation of
#AI
systems, jointly published in Nature Medicine [] and BMJ []
0
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We're expanding our
@QSNeurosurgery
clinical research fellowship programme - our 3 surgical tech fellowships have now been recruited, but for those that are keen on basic science alongside clinical training, look no further than this excellent offering from
@ciaranscotthill
.
🌟Calling all aspiring Neurosurgeons & Researchers!🧬🧠🔪
Join our dynamic team & get hands-on
#Neurosurgery
experience & pioneer
#Glioblastoma
Research.
Don't miss out! Apply now for our Junior Clinical-Research Fellow post.
#QSNeurosurgery
#UCLCancer
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6
30
Artificial Intelligence Tutoring vs Expert Instruction in Simulated Surgical Skills Among Medical Students via
@JAMANetworkOpen
- really strong work by the
@AI_SimCentre
!
#neurosurgery
#ai
#simulation
0
5
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A really nice bit of collaborative research led by
@dzkhan94
- it dovetails work by
@IvoMuskens
and
@mldbneuro
and shows that the "keyhole" endoscope-assisted approach is a reasonable option for anterior skull base meningiomas
#neurosurgery
#endoscopy
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13
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I have now witnessed three Trusts introduce
#EHRS
- without doubt
@uclh
has been best prepared, and already some of the advantages coming through. Well done to
@MarcelLevi
, Gill Gaskin, Chris Turner, and others on their leadership.
#EHRS
#NHNN
0
9
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1/5 Joining the festive story-sharing à la
@KathaSchmack
: My first interview (of any sort):
An anxious 17 year old me applies to
@CaiusCollege
to read medicine…
1
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Oncolytic HSV-1 G207 Immunovirotherapy for Pediatric High-Grade Gliomas - promising work in the NEJM
0
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@QSNeurosurgery
Hugely grateful for the opportunity and excited to get started!
#neurosurgery
#pituitary
#research
13
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The Queen Square Pituitary Fellowship now being advertised. Do get in touch if you are thinking about applying!
#pituitary
#surgery
#fellowship
0
10
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***Calling all trainees***
The QS Pituitary Fellowship now being advertised for next year (Aug ‘23)
#endoscopy
#pituitary
#surgery
0
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@PatrickGrover4
@WFNSHQ
Thanks
@PatrickGrover4
for the shout-out, and to all for the very kind comments. Not sure I’m going to be eligible as “young” very much longer, so glad to have got it!
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Hugely impressive work by our team
@uclmecheng
, and potentially paradigm shifting: why do endoscopy or biopsy when you can get there by imaging alone?
1
3
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Several trainees have already approached me our upcoming pituitary fellowship - the ad has just come out so do apply if keen!
*** Exciting Opportunity from
@QSNeurosurgery
***
We're thrilled to announce our next Senior Pituitary Fellowship.
Great team, lots of operating, and the chance to get involved with cutting-edge research.
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@jordanpfaulkner
This was the best advice I was ever given as a trainee: Judge yourself by your rejections - if you haven't had any, you haven't aimed high enough.
I can confirm that since being given that advice I have had *many* rejections...
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2
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Have improved imaging techniques led to better surgical outcomes in pts with Cushing’s disease? In short, probably not.
My take would be we need better tools and techniques during surgery itself (but I’m biased!)
#pituitary
#cushings
Has improved imaging also improved outcome in pituitary surgery for Cushing’s disease? Great collaboration with
@QSPituitaryUnit
@hani_marcus
@KorbonitsL
@dzkhan94
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6
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“The greatest enemy of knowledge is not ignorance, it is illusion of knowledge.” RIP Stephen Hawking
0
4
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Great review by the Oxford team on
#glioblastoma
👏
Glioblastoma is a primary brain cancer which can arise anywhere within the central nervous system but is most commonly located in the frontal or temporal lobes.
What should you know about its clinical presentation, investigation, and management?
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6
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@QSNeurosurgery
@WEISS_UCL
@dzkhan94
@Hugo_LH
Really well done to two exceptional trainees, and lucky for us that we can now keep them! 👏
0
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0
2
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Excited to announce WEISS Clinical Research Fellowships from Aug
@WEISS_UCL
@QSNeurosurgery
- these are one year 50/50 posts ideally suited to those wishing to strengthen their application for national selection next year.
0
4
21
Creating images from text - the most impressive use of
#AI
I have seen in a very long time, and worth a look if you are at all interested in this stuff. 🤯 I may have to revise my estimate on the emergence of artificial general intelligence...
2
8
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Great to see this project kick off in collaboration with the
@PituitarySoc
. Well done done to
@newall_nicola
&
@avaletopoulou
for leading.
To any patients who have undergone pituitary surgery, and any clinicians or researchers involved in their care - pls get in touch!
Have you been affected directly or indirectly by a pituitary adenoma requiring surgery?
Do you treat patients with pituitary adenomas?
Would you like to improve research within the field?
Then sign up to the
#PitCop
study today ⬇️
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Interested in not just doing research, but doing better surgical research on new tech? global surgery? education?
Join us at the
@RoySocMed
for
#IDEAL2024
in just over 2 weeks to hear from experts, and to get involved in our next project.
Places are limited are going fast -
IDEAL Conference 2024 - Just over 2 weeks to go to book your place!
Hosted by the IDEAL Collaboration, takes a deep dive into three critical areas: Robotics and Artificial Intelligence, Global Surgery and Education.
We are proud to provide a platform to discuss the latest
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It’s a real shame
@QSNeurosurgery
and
@TheWaltonCentre
weren’t included in analysis - really curious to see where we’d have ranked!
#neurosurgery
5-years on: h-index of neurosurgical units in the United Kingdom and Ireland
@KingsNeuro
#Neurosurgery
@WorldNeurosurg
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This will be great -
@PatrickGrover4
is an excellent teacher - just make sure you brush up on your anatomy!
Part 4 of our Journey Through The Encephalon series: Stroke
Sign ups are open!
Make sure you get your ticket through the google form:
Yousif, Jack & Neuro Subcommittee
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1
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Neuroprosthesis for Decoding Speech in a Paralyzed Person with Anarthria | NEJM
1
3
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Over 50 abstracts submitted and places are going fast so please register as soon as possible if you’re keen to come along.
#IDEAL2024
#NoInnovationWithoutEvaluation
Our preliminary programme for the IDEAL Conference 2024 is now available. Please share between your friends and colleagues We look forward to welcoming you! All the best, The IDEAL Team
Info & Registration:
@IDEALCollab
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Impressive work reflecting the steady march towards increasingly autonomous robotic surgery...
0
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Check out this job at WEISS - Wellcome / EPSRC Centre for Interventional and Surgical Sciences: Personal Assistant to Clinical Director and Deputies!
0
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New job alert!
We're looking for a
@WEISS_UCL
Clinical Trials Manager to help bring our new technologies to patients.
To find out more:
#surgery
#translation
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Well done again
@Amir_Zamanipoor
&
@dzkhan94
on more collaborative work. TL;DR - the 20-25% leak rate often quoted for the expanded endoscopic endonasal approach does *not* reflect the recent literature - surgeons are getting better at repairing the skull base!
0
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BRAF–MEK Inhibition in Newly Diagnosed Papillary Craniopharyngiomas | NEJM - pleased to see further treatments added to our armamentarium
#craniopharyngioma
0
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📢 Calling all innovators in surgical robotics! Contribute to our latest research topic: 'Robotics in Surgery: Performance, Safety, and Learning – What Next?' -
#SurgicalRobotics
#MedicalResearch
0
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This is a great piece of work by
@StephenTMagill
looking at the management and outcomes of tuberculum sellae meningioma - increased use of endonasal over time, but surprisingly CSF leak rates haven’t improved much - our
@cranial_study
should dovetail nicely!
#endoscopy
#skullbase
Thank you
@CNS_Update
for the Best
#Clinical
#Research
-
#Tumor
Award. Here's the video abstract for the clinical outcomes from our collaborative International Tuberculum Sellae
#Meningioma
study.
@NeurosurgUCSF
@NSTumorSection
@NASBSorg
#ENT
#EEA
#nsgy
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Well done to
@EmDimitrakakis
, our former PhD student and now proud to say boss in my role at our spin out Panda Surgical!
When
@hani_marcus
,
@DanStoyanov
and I founded Panda Surgical, we did not expect such a busy first year. Looking back at the journey we have embarked on since May, I can say I am very proud of the early milestones our young company has achieved.
Over the last 8 months (1/10)
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Strong agree.
To my fellow surgical colleagues
@Laparoscopes
@p_masca
@aminmadaniMD
@fionakolbinger
@doctor_felix
and all: I asked
#ChatGPT
which medical discipline will be the last to be taken over by AI, and the answer was clear…😉
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To all those (especially trainees) who want to hear about our next IDEAL framework and how to get involved please do come along and hear from
@_JoshBurke_
himself!
#IDEAL2024
#surgery
#innovation
Fantastic to see the interest & engagement with the IDEAL Robotics Colloquium's recent guidelines. If you want to hear more about
#surgicalrobotics
, and other hot topics related to device evaluation, come and join us in London for this year's conference (April 3rd - 4th).
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Always one of my favourite conferences.
Very case based. Invariably lots of thoughtful discussion about the sorts of questions we all encounter day-to-day. And more than once has led to collaborative projects to find the answers!
*** SAVE THE DATE ***
24TH CLINICOPATHOLOGICAL CONFERENCE ON PITUITARY DISEASE
Friday 9th February 2024
Abstract deadline Sunday 3rd December 2023
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Thanks all - in the interests of being open and transparent, I should say that I have also had plenty grants applications *rejected* in the last few weeks too! 🤣
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This is a fascinating finding…
When a long-term memory forms, some brain cells experience a rush of electrical activity so strong that it snaps their DNA.
Then, an inflammatory response kicks in, repairing this damage and helping to cement the memory, a study in mice shows
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Huge congrats to
@AKPritchard2
on being appointed the new head of
@NHSEngland
👏 👏 👏 Wish you every success the new role!
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