The laser ablation treatment consists in the introduction of a laser probe inside the skull of the brain in a very precise way. This is done in the operating room, and then moved to the MRI where we will see how and where the laser has an effect at the same time it is happening.
Within the MRI, heat is generated at the tip of this laser, so that the temperature around the tip of the laser increases in a very controlled manner.
What this does is an ablation, that is to say, the heat denatures the proteins where it is being deposited. When the temperature is below 60ºC, denaturation is dependent on the time of heat applied and is very controlled.
Indications for laser ablation
There are two main indications for laser ablation treatment of the brain. One is epilepsy and the other is brain tumors.
In both cases, ablation is performed when the lesion is very deep, hidden and difficult to access. In these cases, ablation makes much more sense, because the invasion of healthy brain tissue is much less.
It is a laser probe of less than 2 millimeters and, therefore, allows access to deep sites, with minimal invasion. In addition, it allows us to see where the heat is deposited. To do the same with an open treatment, the risk of morbidity and mortality is often higher, because open treatment is more invasive.
Therefore, deep lesions, in riskier territories, are the optimal indication for this treatment.
The results of laser ablation treatment
The results are generally effective, but in any case, the results depend very much on the type of lesion we are dealing with.
For example, in epilepsy, in a medial temporal lobe resection or surgery, which is the most frequent surgery, open surgery has an 80% seizure cure rate. On the other hand, with the laser ablation technique, the percentage is lower. It is 70% of crisis liberation, without having to take medication afterwards. What happens is that it is less invasive and does not prevent that, if this has not led to a complete cure, laser treatment can be repeated or open surgery can be performed.
In general, laser treatment is more beneficial in small and very deep lesions. That is where it has a clear advantage over conventional open treatment. In others, it is simply less invasive, but open surgery is sometimes even more effective. For this reason, it is important to assess each case individually.