What is laser ablation brain surgery?

Laser ablation brain surgery, also known as laser interstitial thermal therapy (LITT), uses heat from precisely focused lasers to treat epilepsy and remove brain tumors. Children’s Hospital of Philadelphia (CHOP) is one of the few children’s hospitals in the country to offer laser ablation surgery for epilepsy and brain tumors.

Laser ablation brain surgery is a less invasive alternative to conventional brain surgery, allowing for a much smaller incision and less disturbance to surrounding brain tissue. The neurosurgeon is guided in the procedure by magnetic resonance imaging (MRI).

The method is especially valuable for removing sources of the seizure activity (seizure foci) and tumors deep within the brain, as well as in cases where removing the diseased tissue would risk damaging healthy brain tissue critical for important cognitive functions.

Who is a candidate for laser ablation brain surgery?

Laser ablation brain surgery is considered as an option for children with seizures or brain tumors when other treatments, such as anti-seizure medication or radiation for tumors, have failed and when the seizure focus or tumor is confined to a small, well-defined area. The procedure is most valuable for treating seizure foci and tumors that are in hard-to-reach parts of the brain.

Laser ablation surgery is also used in corpus callosotomy, a procedure to disconnect all or part of the corpus callosum as a way to treat drop seizures.

How is laser ablation brain surgery performed?

Laser ablation for brain tumors and epilepsy is performed while your child is under general anesthesia using an MRI-guided laser ablation system (Visualase^TM).

It starts with a small hole, about the diameter of a pencil, made in the skull. A thin probe is inserted through the hole, and MRI is used to guide the probe through the brain to the tumor or part of the brain that is the source of the seizure activity.

When the tip of the probe is inside the tumor or origin of the seizure, the laser is activated, using heat to destroy the targeted tissue. This is why the procedure is sometimes called thermal laser ablation. The MRI shows the surgeon where the tissue is being heated and how warm it is getting, enabling precise application of the ablation treatment without damaging surrounding brain tissue.

When the probe is removed, the hole in the skull and scalp is closed with a single stitch.

What to expect during laser ablation brain surgery

On the day of the surgery, your child will undergo general anesthesia. At Children’s Hospital of Philadelphia, you can trust our specially trained pediatric anesthesiologists to keep your child comfortable and safe before, during and after their procedure. Read more about our dedicated pediatric anesthesiology team.

The procedure typically takes about four hours.

Your child will be monitored during recovery from anesthesia. Most children are able to go home the next day.

Your child will be able to resume normal activities in about two weeks.

Your child will come back to CHOP for periodic follow-up visits in the year or two after the procedure, on a schedule determined by your child’s doctor.

Why choose CHOP for laser ablation brain surgery

At Children’s Hospital of Philadelphia, your child will have access to experts from the Division of Neurosurgery, the Pediatric Epilepsy Program, the Pediatric Neuro-Oncology Program, and the Cancer Center, among others who specialize in the care of children requiring brain surgery and epilepsy surgery.

Our team of experts work closely together to ensure that candidates are screened appropriately for laser ablation surgery, and to provide the full range of supportive therapy after surgery to meet your child’s individual needs.