Dr. Meni Brakha

Senior physician in the Department of Oncological Surgery at Hadassah Ein Kerem Hospital, Jerusalem

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Oncological Surgery - Melanoma, Sarcoma and Rare Tumors

Soft tissue tumors, complex surgeries for metastasis removal in limbs and soft tissues, complex tissue reconstructions using skin flaps, metastatic melanoma, metastatic sarcoma, NET tumors.

Dr. Meni Brakha, an oncological surgeon specializing in melanoma and sarcoma operations, leads the melanoma and sarcoma surgery department at Hadassah Ein Kerem as part of a broad multidisciplinary team. A graduate of official fellowship training at Peter MacCallum Cancer Centre (Australia) and training at Moffitt Cancer Center in Tampa, USA. An expert in wide excisions of melanoma and advanced reconstructions (oncoplastics), sentinel lymph node biopsy, extensive lymph node dissection, excision of soft tissue tumors and sarcomas throughout the body (including retroperitoneum, limb-sparing surgeries, and advanced local treatments such as isolated limb perfusion chemotherapy in cases of metastatic melanoma or attempts to preserve limbs in sarcoma diagnosis. Performs all surgical components personally with emphasis on human and empathetic treatment, aspiration for optimal oncological healing and reduction of complication risk as much as possible.

• Senior physician in the oncological surgery department at Hadassah Ein Kerem Hospital, Jerusalem

• Extended specialization in oncological surgery, with emphasis on melanoma, sarcoma and rare tumors at one of the leading cancer centers in the world - Peter MacCallum Cancer Center in Melbourne, Australia.

• Training in oncological surgery at Moffitt Cancer Center in Tampa, Florida, USA.

• Specialization in general surgery at Ichilov Hospital

• Engagement in laboratory research in the field of oncological surgery, and partner in several international clinical research initiatives in the field of melanoma and sarcoma.

• Permanent panel member in a global forum for discussion of complex sarcoma cases

• Manager of sarcoma forum for questions on complex cases - https://www.doctors.co.il/forum-6382

• Medical studies at the Hebrew University of Jerusalem

• Australian College of Surgeons

• American Society of Surgical Oncology - SSO

• American Society of Clinical Oncology - ASCO

• Sentinel Lymph Node Working Group

• European Society for Medical Oncology - ESMO

• TARPSWG - World Association of Sarcoma Surgery Specialists

• Surgeons Association

• Israeli Association for Melanoma and Skin Cancer

• Hebrew

• English

• Cutaneous melanoma – diagnosis and surgery: wide excision, skin reconstruction (oncoplastics), sentinel lymph node biopsy, margin management.

• Melanoma with lymph node involvement - radical lymph node dissection.

• Sarcomas (limb/body/Retroperitoneal): surgical planning for limb/organ preservation.

• Retroperitoneal Sarcoma.

• Rare skin tumors (Merkel/DFSP/NMSC high-risk) and rare soft tissue tumors.

• Dermatofibrosarcoma - DFSP.

• Desmoid fibromatosis - Desmoid Tumor.

• Kaposi sarcoma - lesion excision, intratumoral chemotherapy injection as an alternative to intravenous chemotherapy.

• Breast phyllodes tumor - clinical and imaging assessment, precise surgical planning, personalized surgeries with aesthetic considerations.

• Metastatic melanoma - treatment of in-transit metastases and soft tissue metastases.

• Isolated Limb Infusion - infusion of chemotherapy to the limb only for limb preservation in cases of metastatic melanoma in the limb or limb sarcoma.

• Second opinion before surgery or after partial/incomplete surgery in the field of melanoma and sarcoma.

• Melanoma Surgery - Malignant Melanoma

  • Wide excision of melanoma with complex reconstructions when required for excellent cosmetic results (oncoplastics).

  • Sentinel lymph node biopsy, with precise localization and identification of the lymph node, in an attempt to improve disease control and refine treatment.

  • Radical lymphadenectomy

  • In-transit melanoma resection.

  • Robotic pelvic lymphadenectomy.

  • Skin flaps for reconstruction (alternative to skin graft with significantly better cosmetic results and fewer complications compared to grafts).

  • Primary biopsy of suspicious lesions in skin and soft tissues.

  • Surgery for resection of melanoma metastases in internal organs.

  • Consultation and second opinion for complex cases with primary or metastatic disease.

  • Complex surgeries for other skin tumors.

  • Axillary dissection/lymphadenectomy, specialized surgery for melanoma with involvement of deep lymph nodes (element not performed in lymph node surgery for breast cancer).

  • Inguinal lymphadenectomy/groin dissection - complex surgery with removal of all lymph nodes in the groin in one block, attempting to minimize the chances of local/regional disease recurrence.

  • Pelvic lymphadenectomy - performing the surgery both through open approach and robotically, decision made for each individual case with attempt for maximal control of regional disease.

  • Resection of melanoma metastases for production of personalized autologous vaccine in cases of inability to receive immunotherapy, and after discussion and evaluation by our comprehensive melanoma team.

  • Neck dissection of lymph nodes in cases of metastatic melanoma in cervical lymph nodes, when indicated.

  • Surgery for resection of hepatic metastases of uveal melanoma.

• Sarcoma surgeries - Soft Tissue Sarcoma

  • Resection of retroperitoneal sarcoma - tailoring specific surgery to the precise sarcoma subtype, with attempt to preserve organs without oncological compromise.

  • Resection of dermatofibrosarcoma protuberans (DFSP) throughout the body, with optimal oncological outcomes and emphasis on cosmetic aspects.

  • Desmoid tumor surgeries - meticulous assessment of disease status, often healing without any surgery, desmoid surgeries when indicated with attention to cosmetic elements.

  • Cutaneous sarcomas of the scalp, head and neck - surgeries for Pleomorphic Dermal Sarcoma and other cutaneous sarcomas such as Leiomyosarcoma.

  • Metastatic sarcoma in the abdominal cavity - especially after unsuccessful primary surgery performed previously, with attention to disease biology and meticulous assessment in attempt to achieve cure when possible.

  • Isolated Limb Infusion of chemotherapy in minimally invasive approach, for limb preservation in cases of limb sarcoma requiring amputation.

  • Angiosarcoma surgeries, including cases of radiation-induced angiosarcoma.

  • Breast phyllodes tumor - complete assessment before surgery, tailoring the required surgical type to tumor grade, breast-conserving surgeries and oncoplasty.

  • Liposarcoma/Atypical Lipomatous Tumor - surgeries for liposarcoma tumors throughout the body, including extremities, chest, abdominal wall. Limb-sparing surgeries, with local cosmetic reconstructions (oncoplasty).

  • GIST surgeries - surgeries for both primary tumor and metastatic disease when control cannot be achieved at disease site with drug therapy.

  • Retroperitoneal Leiomyosarcoma - extensive experience in complex surgeries for leiomyosarcoma resection, sometimes requiring resection of major blood vessels to achieve cure and vascular reconstruction with grafts. Surgeries are performed as part of the comprehensive sarcoma team with full interdisciplinary cooperation to achieve optimal results.

  • Kaposi Sarcoma - surgeries for sarcoma and lesion resection when indicated, alternatively local injection of chemotherapy into the tumor (without systemic effects) with excellent results.

  • Initial assessment and thorough investigation of new soft tissue mass appearance - targeted imaging, decision on biopsy method, expediting investigation when necessary and building personalized treatment and surgical plan.

  • Surgeries for benign lipomas and advanced lipomas, including complex cases.

• Merkel Cell Carcinoma - Merkel Cell Carcinoma

  • Evaluation of Merkel cell tumor - sometimes the decision that surgery is not necessary with identical chances of healing, sometimes the need for tumor removal.

  • Sentinel lymph node sampling in Merkel cell carcinoma - a critical element in treatment with the need for accurate identification of the lymph node, for the purpose of deciding on radiation delivery to the lymph node area in order to control the disease and prevent its progression.

  • Surgeries for metastases of Merkel cell carcinoma, mainly along the limbs but also in soft tissues.

• Surgery for Peripheral Nerve Tumors - Peripheral Nerve Tumors

  • Assessment and analysis directed at Malignant Peripheral Nerve Sheath Tumor (MPNST).

  • Wide excision of neural tumors with neurovascular preparation.

  • Surgery for schwannoma tumors.

  • Surgery for neurofibroma and neurofibromatosis tumors.

  • Surgery for perineurioma tumors.

  • Surgery for granular cell tumors.

• Surgery for rare non-melanoma skin tumors - Non-Melanoma Rare Skin Cancers

  • Surgery for Porocarcinoma tumor.

  • Surgery for Adnexal Skin Tumors and hair follicle tumors.

  • Surgery for Sebaceous Carcinoma.

  • Surgery for advanced Squamous Cell Carcinoma.

  • Surgery for rare cutaneous sarcomas including Pleomorphic Dermal Sarcoma and Undifferentiated Pleomorphic Sarcoma.

• Surgery for Retroperitoneal Sarcoma - Retroperitoneal Sarcoma

  • Planned multivisceral resections.

  • Margin planning and organ-sparing procedures depending on the specific biology of the disease and individualized treatment plan.

  • Combined surgeries with major vascular resections and vascular reconstructions.

  • Surgeries for retroperitoneal liposarcoma.

  • Surgeries for retroperitoneal leiomyosarcoma.

  • Surgeries for retroperitoneal solitary fibrous tumor.

  • Surgeries for small round blue cell tumors of the retroperitoneum.

  • Surgeries for malignant peripheral nerve sheath tumor.

  • Surgeries for all malignant and benign tumors of the retroperitoneum.

  • Surgery for metastatic retroperitoneal sarcoma.