New surgical technique uses laser energy to destroy brain tumors

Novel approach is minimally invasive and precise
04:20 PM CDT on Wednesday, October 7, 2009
Wendy Rigby / KENS 5

Perez has had one surgery to remove the tumor, but now the cancer has returned. This time, Dr. John Floyd, a U.T. Health Science Center neurosurgeon, is trying something different.

In an operating room at St. Luke’s Baptist Hospital, the doctor secured an anchor in the outside of the skull. Then, using what’s called neuro-navigation for precision, he slid a catheter several inches inside the head. That catheter houses a laser that can zap the cells growing out of control and threatening Perez’ life.

After the catheter was in place, the patient was moved to an MRI suite, where real-time images showed the doctors the area they were treating.

“Now we have another surgical technique which is minimally invasive and excellent for recurrences,” Floyd said.

While the two-step procedure took several hours, the heating and killing of the tumor took less than five minutes.

“In fighting brain cancer and brain tumors, we need everything that’s available at our disposal to be able to win the battle,” commented Dr. David Jimenez, head of the neurosurgery department at UTHSC.

Full article and video at News5

Ray Turner, 33, a Medical University of South Carolina neurosurgeon, performed the first laser brain surgery in the hospital’s history, only the 10th performed in the United States and the 30th in the world. “It’s exhilarating,” he said Thursday. “This is what we want to do in medicine, stay on the cutting edge.”

Rare laser brain surgery a first at MUSC – The Post And Courier Charleston, SC

30 Minute Brain Surgery – WCIV ABC News 4 Charleston, SC

Burning out brain tumors: new procedure shows promise

Posted: Apr 20, 2009 5:59 PM CDT Updated: Apr 28, 2009 11:51 AM CDT
By Carolyn Roy, KSLA News 12

SHREVEPORT, LA (KSLA) – A Shreveport neurosurgeon has taken brain surgery for the removal of tumors to a whole new level, finding a way to obliterate a tumors, with much less risk.  A Many, Louisiana woman was the first patient in the U.S. to have the procedure done.

Karen Mowad … has been through surgery, chemotherapy and radiation…, but when the cancer spread to her brain, she came to Dr. Ravish Patwardhan of the Comprehensive Neurosurgery Network.

The Shreveport neurosurgeon had to open her skull to remove that tumor.  It’s the kind of surgery that leaves a big scar and comes with serious risks and a longer recovery time.  But by the time another tumor appeared last fall, Dr. Patwardhan had a new tool to try: a laser probe, and he was looking for a patient willing to be the first.  “We offered her both options,” says Dr. Patwardhan. “We said, ‘Look, you’ll be the first one in, really, North America to have this tumor re-sected for a metastatic brain tumor.  If you’re interested in it, we can do this. It involves making a small opening and going in and burning it.”  The alternative was another open operation.  Mowad was in.

The procedure, marries the precision of navigation tools … with an MRI-guided laser probe developed by Visualase out of Houston. “What this does is you just have to make a hole that will take you to the middle of the tumor, burn the tumor and then the tumor will essentially evaporate.  It’s actually done in the MRI suite, so when the probe is confirmed to be in the correct position in the MRI suite what you do then is heat it and you can watch it directly on the MRI scanner what area is being heated using the program.  After that you can do another MRI scan, since the patient is already there to show the tumor is gone.  So you have instant gratification.”

The procedure leaves behind a small pinpoint incision, comparable to that size of the tip of a pencil.  Karen Mowad was able to stay awake through the procedure, and felt no significant discomfort.  In addition to avoiding the risks related to anesthesia, the laser ablation probe is thin and slides through the brain with much less disturbance.  It allows the surgeon to reach even deep tumors with far less risk, like the brain swelling that comes with conventional procedures.

“It’s so much simpler and easier on the patient than a conventional procedure,” says Dr. Patwardhan.   It’s also faster, and it appears to be just as effective, if not more so.  Mowad’s surgery came at the end of one week.  She was back at work by the beginning of the next.  (Please note Visualase is effective in ablating tumors. It is not a cure for cancer.) Six months later, there is still no sign of the tumor.  “The number of people who make it out one year with a metastatic brain tumor is very low,” explains Dr. Patwardhan.  “She’s actually functioning and working, which is incredible.”

“It’s because of a lot of what I’ve been through, you know, I want other people not to be afraid of this.”

Since Mowad became the first patient in North America to undergo the procedure, several others have followed.  For now, Dr. Patwardhan says they’re reserving the laser treatment for brain tumors as a last resort, as long as patients’ conditions meet certain criteria.  “It’s restricted for tumors where you can go into them, which are tumors that are not extraordinarily hard, but there are quite a few tumors that are amenable to this treatment, so that’s nice.”

Click here to view the embedded video.

Click here to view the embedded video.

“Lasers used in keyhole surgery for brain cancer” – Agence France-Presse

Paris, France August 29th, 2008 – Visualase technology used to successfully treat brain tumors, as reported by AFP and the Telegraph (UK).

Read: AFP article | Telegraph article

Paris hospital hosts pioneering laser brain surgery

Saturday 30 August 2008 – A French team of neurosurgeons claims top have successfully tested a combination of new techniques, including fibre-optic lasers, in treating brain cancer through ultra-keyhole surgery.

Read: France24