What Is Laser Interstitial Thermal Therapy (LITT)?
Laser interstitial thermal therapy (LITT), also known as MRI-guided laser ablation, is a minimally invasive neurosurgical technique to treat certain brain tumors, epilepsy, and abnormal blood vessels in the brain called cavernomas that can cause seizures. It is used by neurosurgeons as a less-invasive alternative to open craniotomy, in which a portion of the skull is removed for access to the brain.
Penn Medicine surgeons have performed hundreds of LITT procedures, making them among the most experienced in the nation. We use the Visualase™ laser ablation system for the LITT procedure. This system uses a laser to destroy, or ablate, tumors or precise areas of brain tissue that cause seizures. Doctors use a magnetic resonance imaging (MRI) scanner during the procedure to accurately guide the laser and control the temperature of the tissue. Continuous MRI scanning during the procedure allows doctors to target specific tissues while leaving nearby tissues unharmed.
Who Is a Candidate for the LITT Procedure?
If your seizures continue even after you’ve tried several anti-seizure medications, your doctor may recommend surgery. Laser interstitial thermal therapy is an option for people with very localized seizures (seizures that are limited to one area of the brain).
LITT is not appropriate for everyone. Those who may not be good candidates for this procedure include:
- People with pacemakers, neurostimulators, drug infusion pumps, or other implanted medical devices who cannot have MRI
- People who cannot have brain surgery because of other medical conditions
- People with generalized seizures, who may respond better to other surgical treatment options, such as deep brain stimulation (DBS)
What to Expect During Laser Interstitial Thermal Therapy
LITT is an inpatient procedure that takes a few hours. You receive general anesthesia to keep you asleep for the entire procedure. Before the ablation, your surgeon carefully plans the procedure using special software for improved accuracy.
During laser interstitial thermal therapy, your neurosurgeon:
- Makes a tiny incision through the scalp.
- Makes a small hole (the width of a thin pen) through the skull.
- Places a small, flexible laser probe into the target brain area.
- Places you in the MRI scanner to be sure the laser probe is in the correct spot.
- Turns on the laser and monitors the heat level of the brain tissues in real-time using the Visualase system.
- Turns off the laser when ablation is complete.
- Removes the laser probe and closes the incision.
Laser Thermal Ablation Recovery
Most people spend one night in the hospital after laser thermal ablation surgery and go home the next morning. You should be able to return to work and other activities within about a week.
The most common side effect after interstitial laser thermal therapy is a headache caused by swelling from the surgery. Some people may also have mild, temporary problems with memory, language, and weakness.
You see your neurosurgeon for follow-up appointments one month and three months after the procedure. You also have regular follow-up appointments with your neurologist, typically at two weeks and then every three to six months after the procedure. Regular check-ups allow your doctors to monitor your progress and manage any symptoms.
Benefits and Risks of LITT for Epilepsy
Around 50 to 60 percent of people with epilepsy who have laser interstitial thermal therapy achieve seizure freedom (a total halt to seizures).
Because LITT is a minimally invasive procedure, it has other benefits compared to open brain surgery, including:
- Access to deeper areas of the brain that aren’t accessible with open procedures
- Decreased scarring, pain, and side effects
- Decreased time spent in surgery
- Faster recovery after surgery
- Lower infection risk
- Lower hospital readmission rate
- Shorter length of hospital stay
Complications of LITT are rare but may include:
- Bleeding in the brain
- New neurological problems such as memory problems or visual disturbances
Why Choose Penn Medicine for Laser Interstitial Thermal Therapy?
Penn Medicine’s Comprehensive Epilepsy Center is home to neurologists and neurosurgeons with decades of experience treating even the most rare and complex conditions.
People who choose us for laser interstitial thermal therapy find:
- Minimally invasive treatment: LITT provides effective treatment for epilepsy, brain tumors, and cavernomas without open brain surgery. You recover more quickly, with fewer side effects. Our team works closely with you to make sure MRI-guided thermal laser ablation is right for you.
- Deep experience: Penn neurosurgeons are national leaders in advanced surgical techniques for seizures. Our team has performed hundreds of ablations, placing us among the most skilled and experienced physicians in the nation.
- Advanced imaging: Real-time MRI scanning provides the most updated brain images possible during laser thermal ablation. Using this leading-edge technique allows our neurosurgeons to perform extremely precise ablation, so you get the best results possible.
Make an Appointment
Please call 800-789-7366 or make an appointment.