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Laser Ablation: A Minimally Invasive Surgery for Epilepsy Treatment

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To learn more about the best treatment for your epilepsy, contact the UW Health Epilepsy Clinic at (608) 263-9578.

UW Health offers laser ablation therapy to treat patients suffering from epilepsy not controlled by medication. This is a minimally invasive surgery made possible by advances in fiber-optic technology and MRI scanning. Laser ablation surgical technology was approved by the FDA in 2010. UW Health is a leader in the surgical treatment of epilepsy, and one of the only centers in this region to offer laser ablation.

 

How Laser Ablation Surgery Works

 

The laser ablation procedure places a small fiber-optic probe (twice the size of a pencil lead) into the area of brain causing seizures. Laser ablation then heats the abnormal brain area that is causing seizures, effectively stopping or reducing seizures coming from this area. During the procedure, an MRI scans the patients brain to assure that the fiber-optic probe is in the correct place and that the heating is working as planned.

 

Who is a candidate?

 

Patients that have epilepsy not controlled by medications need to be evaluated to see if surgery can improve their seizure control. If a patient with poorly controlled epilepsy is evaluated and found to have a brain area that is causing seizures they can be considered for a laser ablation procedure.

 

What are the advantages?

  • Laser ablation surgery is considered a minimally invasive surgical treatment because it doesn't require a large incision or a large opening in the skull.
  • For laser ablation surgeries the incision is typically 1cm in size (less than a ½ inch). A small opening is created in the skull (about the size of a pencil eraser). The fiber-optic probe inserted into the brain is small (twice the size of a pencil lead).
  • Laser ablation can allow surgeons to treat deep areas of the brain that can't be safely reached with traditional surgery.
  • Due to the small incisions and minimally invasive nature of this procedure, patient comfort may be improved. Most patients go home after only one night in the hospital.

What are the risks?

 

All surgery carries risk. It is the role of the epilepsy team to minimize the surgical risks while maximizing the benefit to the patient. Risks specific to laser ablation include placing the laser probe in an inappropriate brain area or heating an inappropriate brain area. These risks are reduced by using MRI scans throughout the surgery. This MRI imaging during the procedure updates the treatment team to the exact position of the fiber-optic probe and the real-time status of laser heating.

 

How long is the surgery?

 

The surgery typically lasts 4 to 5 hours. Much of this time is spent placing the fiber-optic probe in the exact spot required for the surgery. The heating portion of the surgery often takes around 1 hour. MRI scanning during the surgery verifies the exact placement of the fiber-optic probe and assures proper heating.

 

What is the recovery time?

 

Most patients go home from the hospital one day after the laser ablation surgery. They gradually resume all of their normal activities over the next couple of weeks. It is important to point out that people recover at different rates and the needs of each patient are different. The surgical team works to create a recovery plan that is specific for each patient.

 

What are the results?

 

Although studies are still being done many doctors believe that results for laser ablation are similar to those of open surgery. Most patients that undergo laser ablation therapy for epilepsy will either stop having seizures or have a major reduction in their seizures.