Watch as Wylie H. Zhu, M.D., presents a case where the patient presented with known brain metastasis and the tumor had returned. LITT (Laser interstitial thermal therapy) was chosen as the treatment option, and Dr. Zhu performs this minimally invasive approach, guided by an interoperative MRI to successfully ablate the brain lesion.
Hi, I'm Wiley's. Ooh, I'm a board certified neurosurgeon with Sentara neurosurgery specialist. Today, we're gonna introduce you a minimally invasive treatment option for brain tumor. It's called laser interstitial thermal therapy or lit. This patient has a known diagnosis of brain metastasis and has that previous treatment of radiation. And follow up, we found that the brain tumor has come back and after discussion of different treatment options and she has chosen to use lit to treat her brain tumor pre operatively, we map out the trajectory of the approach based on preoperative M R I and patient is asleep and we put on stereotyped radio, stereo, attacked IQ head frame. And afterwards, Annan traveling imaging was obtained to calculate the coordinates for the targeting software. And this was verified after the scan to merge with preoperative skin to be utilized during surgery. Here, the coordinate is set on the targeting frame which is attached to the patient's head in a smart decision in a small hole is drilled to the skull and afterwards a boat anchor was placed, we then proceed with a tissue biopsy using a 1.5 millimeter needle. This is sent two pathologists where confirmation was obtained. We then transfer the patient to the intra operative M R I suite where the rest of the procedure is performed. Here, we attach the robotic device to be used during the treatment. Afterwards, the laser probe will be inserted into the patient's head. The robotic device is then used through the computer software to target the lesion in real time M R I imaging is done too obtain the treatment result here. The blue line indicates the effect of treatment using laser. The robotic device also advanced the probe through different depths to make sure all the tumor is being treated. The laser probe is able to be rotated 360° to make sure all the area of interest is treated after a surgery. A set of imaging was obtained to show the treatment effect. And our follow up, we can see that lesion has been absorbed gradually by the brain tissue. The patient was observed after surgery overnight and released home.