Laser Ablation

For laser ablation surgery, your child is placed under general anesthesia, will not feel any pain, and will not move, which is important for the treatment to be precise.

A frame is then placed around your child's head to help the surgeon insert a probe in the best place to reach the lesion. The probe is a thin, 1.65 millimeters (in diameter) flexible tube about as wide as a pencil lead. It holds clear fibers that emit light.

The surgeon makes a small incision (3.2 millimeters) in the scalp. The small entry point means most patients have little or no hair removed. The surgeon then makes a small hole the same size in the skull and inserts the probe. The probe’s pathway made through your child’s brain is very narrow and is much less likely to cause damage that could affect brain function.

After probe insertion, the surgical team moves your child into the MRI scanner. Using the MRI display, the surgeon confirms the precise placement of the tip of the probe in the brain. MRI guidance allows surgeons to position the probe in the exact spot within a millimeter tolerance applying heat only to the lesion and protecting healthy surrounding tissue.

The surgeon then turns on the laser. Light comes out of the tip of the probe and the monitors show precisely where and how warm the tissue is getting. From this, the surgeon can judge how much laser treatment is needed.

When the laser treatment is complete, the surgeon removes the probe and closes the incision typically with a one-stitch suture. Amazingly, the treatment itself, when the laser is on, takes only a few minutes. The careful set-up and mapping the pathway to the affected area before treatment takes longer. The total time under anesthesia is about four hours.

There are three key advantages to the precision of laser ablation surgery at Barrow Neurological Institute at Phoenix Children’s:

1. As the only center in the world with the capacity to provide resting-state MRI to isolate a lesion, we have unmatched precision in identifying the affected area to treat
2. Precision in mapping the best possible pathway to the lesion to minimize contact with healthy parts of the brain
3. Precision in treating the actual lesion as the laser heats only the targeted area, significantly reducing negative impacts on brain functions (vision, movement, memory, language, learning, etc.)

In summary, like all surgery, laser ablation is not without some risks, such as the risk of infection. Also, there may be some chance of affecting a healthy part of the brain. This depends, in part, on where the tumor or lesion is located. Our team will talk with you about the risks for your child.

The results can also vary. About half of patients with epilepsy become seizure-free, sometimes within a week. This is about the same success rate as with open surgery, but with less risk. Some patients still have seizures, but they are less severe or happen less often. It could take up to a year to know the full results because the brain requires time to heal after surgery.

Additionally, children who have undergone laser ablation surgery may still have open surgery at a later date if laser ablation surgery failed to cure their lesion.

Diana Larocque, Neurology Nurse Program Coordinator
P: 602-933-0468
%20dlarocque [at] phoenixchildrens.com (dlarocque[at]phoenixchildrens[dot]com)