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What Is Laser Ablation Surgery?

Laser ablation is one of the best alternatives to invasive procedures like craniotomies (temporarily removing a piece of the skull to access the brain during surgery).

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Laser ablation is extremely effective for treating seizures or OCD symptoms in patients who do not get better after taking medications.

Best Candidates for Laser Ablation Surgery

Picture of male doctor holding a brain scan

Before opting for surgery, your doctor will review your medical history and conduct image testing to learn more about your condition. Most patients will not be considered for surgery until they try medications or other types of treatments.

The patients who benefit most from laser ablation will have:

  • uncontrolled seizures after trying other therapies, medication, and dietary changes,
  • brain tumors or abnormal tissues that cause seizures,
  • seizures deep inside the brain where doctors cannot operate using traditional surgery,
  • treatment-resistant OCD,
  • small lesions or very specific areas where seizures occur,
  • hypothalamic hamartoma (tumors that form during fetal development), or
  • tuberous sclerosis (a rare disease that causes tumors or growths in the brain),
  • mesial temporal lobe epilepsy (the most common type of epilepsy), or
  • cortical dysplasia (brain abnormalities that form before a child is born).

Benefits & Risks of Laser Ablation Surgery

The benefits of laser ablation surgery include:

  • a less invasive and safer procedure than an open brain craniotomy (temporarily removing a piece of the skull to access the brain for surgery),
  • a lower chance of damaging healthy tissues during surgery,
  • shorter surgery time,
  • smaller incisions and holes in the bone to insert the laser,
  • no need to shave the surgical site (patients keep their hair),
  • less scarring and pain after the procedure,
  • an ability to treat areas deep in the brain that a surgeon cannot reach,
  • shorter hospital stay and quicker recovery, and
  • fewer complications than traditional craniotomies.

However, laser ablation does have some risks. While they are rare, some reported complications include:

  • narrowing vision,
  • bleeding in the brain,
  • nerve damage, and
  • infection, which is a risk with any surgery.

Talk to your doctor about the risks for you or your child before deciding which surgery is best.

Find a Laser Ablation Surgeon

How Laser Ablation Works

Laser ablation uses lasers to surgically remove tumors or the part of your brain that causes seizures or OCD symptoms. Patients who get laser ablation surgery will still be under general anesthesia (put to sleep) during the procedure. Your surgeon will make a small incision (cut) in the skull (about the size of a pencil) to place a guided laser probe into the brain. Your surgical team will use MRI (magnetic resonance imaging) to map out the exact spot they want to go. This method of using lasers and MRI mapping targets a seizure location with pinpoint accuracy.

Once they find the spot, the neurosurgeon will use lasers to target the spot in the brain where seizures occur. The laser will convert to thermal energy (heat) inside your brain and destroy the specific brain cells that cause seizures or OCD symptoms.

During the procedure, your team will monitor the temperature in nearby areas of your brain with a computer. Your spinal fluid keeps those areas cool to prevent damage to healthy brain tissue outside of the seizure location. Once the surgery is complete, your surgeon will close the small hole he or she made in the bone and the skin with a single stitch. You will spend only one to two nights in the hospital to recover after surgery.

Length of Surgery

A patient will typically be under anesthesia for four to five hours during laser ablation surgery. However, most of this time is spent on MRI scans and planning to verify the exact location and prepare for the procedure. The actual laser portion takes around one hour. 

Laser Ablation Success Rate

Epilepsy Success Rate

In many patients, this surgery will successfully stop their seizures; however, you may need more than one surgery. Some people still have seizures after brain surgery or seizures that come back later. Continue to see your neurologist and epilepsy care team after surgery to ensure the best recovery and outcome. 

Treatment-Resistant OCD Success Rate

Surgical treatments for treatment-resistant OCD have shown to be effective in 60-70% of patients. This means there was at least a 35% reduction in disease severity, allowing these patients to go back to their active life and work.

Laser Ablation Surgery Recovery

It takes about two weeks to recover fully and resume normal activity at home after leaving the hospital. However, some people may require more recovery time and your surgical team will give you a recovery plan that takes your health and medical history into account.

Next Steps

If you have epilepsy, you will need to get a referral from your primary care provider or neurologist to be seen at our comprehensive epilepsy clinic for laser ablation.

To inquire about laser ablation for treatment-resistant OCD, you will need to fill out a screening form and get a referral from your primary care provider or psychiatrist to be evaluated for our psychiatric neurosurgery program.

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