Brain surgery using a laser and a robot to fry cancerous tumors hidden beneath the skull?
It may sound like science fiction, but this innovative technique is already being used to help University of Minnesota Health brain cancer patients.
University of Minnesota Health Neurosurgeon Matthew Hunt, MD, recently performed the system's first laser ablation surgery on a brain cancer patient with a little assistance from ROSA, a robotic surgery arm.
Laser ablation surgery uses light to heat and destroy cancerous tumors or other lesions. For years, the technology has been used to successfully treat cancers on other parts of the body, including prostate cancer and skin cancer. But only recently have medical advancements like the ROSA robotic arm made it possible for surgeons to tackle brain cancer with laser ablation.
Brain surgery has a thin margin for error, and tumors are often located near important areas of the brain that control a vital body system or function. For this reason, many patients with brain cancer are not always eligible for open surgery because the risk of a complication is too high.
But the ROSA device, implemented last year at University of Minnesota Medical Center, improves precision and helps guide surgical teams during brain surgery, enabling surgeons to make use of laser ablation techniques.
“[The ROSA arm] allows us to be confident with the trajectory and extremely precise,” Hunt said.
During a laser ablation procedure, the surgical team drills a small hole in the skull and inserts a probe at the location of the tumor. The team then uses magnetic resonance imaging (MRI) to monitor the positioning of the probe and the temperature of the tissue targeted by the laser ablation.
Laser ablation heats the area. Once it reaches the appropriate temperature, the cancerous cells are destroyed with a minimal impact to nearby healthy brain tissue. University of Minnesota Health neuro-oncologists make use of Visualase® technology, produced by Medtronic.
“The technology is so precise. When it gets to the necessary temperature, it stops,” Hunt said.
“This technology is especially important when we are dealing with hard-to-reach locations,” Hunt said. “Being able to that without exposing the brain in open surgery makes life easier for the patients.”
Traditional brain surgery is invasive and often requires a two- to three-day hospitalization period following the procedure. Laser ablation is much less invasive, because the surgical team is only required to make a small incision—less than a quarter-inch in diameter—in the skull. Hunt hopes this will reduce recovery times.
“When you are talking about cancer patients, time spent in the hospital matters. If we can use a treatment that keeps them out of the hospital, that’s great,” said Hunt.
Not only does this technology allows doctors to reach more tumors, it can also minimize the risk of damage to healthy areas of the brain, making recovery easier and allowing patients to return to “normal” life free of complications.
Though laser ablation brain surgery is available to University of Minnesota Health patients, it’s considered an emerging technology and is not widely available. Hunt and colleagues are now exploring other ways to leverage the technology beyond brain surgery.“We’d like to be able to treat more with this technology. The opportunities this opens are promising,” said Hunt.