Laser Ablation (LITT)

How It Works

A thin laser fiber is placed along a planned path to the target using stereotactic guidance. Inside the MRI scanner, the laser heats a small, controlled volume of tissue. MRI temperature maps update every few seconds and show the treated area forming, so that Dr. Bari can shape the treatment to the target and stop the moment it is complete. Nearby structures are protected by temperature limits set in advance.

What Dr. Bari Treats With LITT

LITT is used where a small, well-defined target needs to be treated without an open operation:

• Epilepsy: ablation of a seizure focus, such as the hippocampus in mesial temporal lobe epilepsy, or a small malformation, when the focus has been identified by the epilepsy evaluation and, where needed, stereo-EEG.
• Cancer pain: cingulotomy, a small lesion in the anterior cingulate cortex that reduces the suffering caused by severe pain when medication has failed or is no longer tolerated.
• Selected tumors and other deep lesions, planned with the neuro-oncology team.

What To Expect

The procedure is performed under general anesthesia. Placing the fiber takes a short time; the ablation itself is done in the MRI scanner and typically lasts minutes. The opening is closed with a single stitch. Most patients go home the next day and return to normal activity within days. Because no brain tissue is removed, recovery is usually faster than after open surgery.

Tradeoffs

LITT treats a small volume, so it is suited to well-defined targets rather than large or irregular ones. For epilepsy, the chance of seizure freedom after ablation of a temporal focus is somewhat lower than after open resection, in exchange for a smaller procedure and often better preservation of memory and language. These tradeoffs are discussed in detail before a recommendation is made.