Brain Cancer Options Comparison Table – Visualase LITT and brain surgery tumor removal
Every case is different and this in no way represents your treatment options. A patient’s case is always specific to them and must be discussed with their treating physician as to what may be an appropriate treatment for them. If in doubt, the patient should consider a second or third opinion..
| Method | LITT | Open Brain Surgery |
| Industry Name | Visualase | Craniotomy, open craniotomy, endoscopic brain surgery, surgical resection |
| Description | Laser targets and destroys the unwanted tissue in minutes. The impact is immediate and the tumor cells are dead at the moment the ablation is complete. | The tumor is physically removed by excisional (knife-cutting) surgery. |
| Invasiveness | Minimally-invasive. Target is accessed through a small 3mm diameter hole and the entry site is closed with a single suture. |
Highly invasive. Craniotomy could be from 1/2″ to 4″ skull opening, plus removal of healthy brain cell tissue to reach the tumor. One or more metal plates are generally required to reattach section(s) of skull removed during the procedure. |
| Anesthesia | Patient can be wide awake with local anesthesia only or sedated to various levels. | Patients are usually fully anesthetized. Specialized surgeries near eloquent areas may be done under local anesthesia with sedation. |
| Pain | Little or no pain during or after procedure. | Little pain during procedure; Healing skull and skin can cause pain for weeks after procedure. |
| Procedure | In an operating room, a small hole is drilled in the skull, and a flexible laser probe (thinner than a standard pencil lead) guided to the target area (about 30 minutes). The patient is moved to an MRI unit and imaged repeatedly while laser energy is applied (about 20 minutes). After treatment, extra images of the brain are taken (about 20 minutes). The patient is then removed from the MRI machine, the laser applicator is removed and the entry site closed (5 minutes) without need to return to the OR. | A large incision exposes the skull, and a surgical saw is used to cut a hole (bone flap) in the skull. The bone flap is removed and set aside. The surgeon uses a probe to search for the tumor and then removes it with conventional or electrical scalpel(s). The bone flap is then replaced and secured with metal screws and plates, and the scalp and muscle are sutured closed. |
| Post-procedure | Brain reaction to thermal treatment includes some short-term swelling. Your surgeon will prescribe steroids which will be tapered off over about a month. Entry wound heals quickly. | Recovery from anesthesia may take up to several hours. May experience pain in the region of the incision, caused from surgical retraction of tissue as well as inflammation and swelling about the incision. |
| Recovery | Patients are 100% functional immediately after procedure. Usually stay overnight for observation. | Patient will be in the Intensive Care Unit (ICU) for the first 24 hours. Head dressing and possibly a surgical drain will remain in place for one to two days. Sutures or staples will be removed in approximately 10 days. |
| Contraindications | Must be able to undergo MRI. Visualase laser ablation does not limit use of other therapies. | Poor health status. On-going chemotherapy. Other age and health factors (bleeding disorders, heart, liver, kidney disease, etc.) |
| Complications | The Visualase procedure is a relatively new treatment. No serious complications are yet known or reported. The size and shape of some tumors may make it impossible to treat the entire tumor with the laser probe in which case it may regrow over time. |
Brain swelling, stroke, memory problems, speech difficulty, paralysis, abnormal balance or coordination, coma. Tumors may recur or regrow if some of the tumor tissue was left behind during surgery. |
| Side Effects | No serious side-effects are yet known or reported. Minor swelling, usually controlled with drugs. | Hair loss, nausea, vomiting, sleeping problems, headaches, pain. |
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Laser Thermal Ablation (LITT) and Stereotactic Radiotherapy (SRS) Comparison Table
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