Laser ablation for lesions and tumours

Laser ablation is a modern technique for treating tumours, lesions or areas that cause epilepsy. At Teknon, in some cases we perform mixed procedures combined with laser ablation.

Address: Gerardo Conesa

THE TEAM

  • Neurosurgery: Gerardo Conesa, Jose Hinojosa

Laser ablation surgery, also referred to as Laser interstitial thermal therapy (LITT) is a novel technique for treating a wide range of tumours, radiotherapy injuries, areas that cause epilepsy refractory to medical treatment, cavernomas, and many other conditions. Over the last decade, very small laser probes (1.3 mm) have been developed that also feature an integrated cooling system. Using precision methods known as stereotaxy, 1 to 3 of these laser probes are placed after planning the entry point, trajectory and target point inside the brain, tumour or lesion to be treated.

Once the laser probes have been positioned in the operating theatre, the patient is transferred to the MRI scanner, where a series of images are taken to show where the heat generated by the laser at the tip of the probe is deposited. We use the Medtronic Visualase system at the Institute of Neurosciences to define a series of safety points on the MRI images where we do not want the temperature to rise, and automatically stops the laser if these temperatures are reached in risk areas. It also assesses how heat is deposited in the lesion. Temperatures between 40°C and 60°C degrade proteins in a manner dependent on the duration of exposure to heat, a process known as ablation. It is a highly controlled process that uses thermographic sequences to determine where the heat generated by the laser is deposited at any given moment, with information accurate to temperature changes of less than one degree Celsius.

Not all lesions can be treated with laser therapy. Heat opens the blood-brain barrier locally, and in cases of ablations of a certain size, it can cause unwanted cerebral edema, so it is generally not used on lesions larger than 3 cm. For this reason, mixed conventional surgical procedures combined with laser ablation are increasingly being performed for large lesions and deep areas, in order to minimize risks and take advantage of the benefits of both procedures.

PROGRAMMES

Laser ablation for:

  • Drug-resistant epilepsy (amygdalo-hippocampectomy, cortical dysplasias, deep brain lesions, etc.)
  • Hypothalamic hamartomas
  • Malignant glioma
  • Brain metastases
  • Cavernomas
  • Meningiomas
  • Radiation necrosis