8 June, 2023
barnaclinic+ incorporates laser ablation for the treatment of brain tumours and epilepsy
In 2021, the Clínic de Barcelona incorporated laser ablation in the treatment of some patients with brain tumours or epilepsy. This technique is now available at barnaclinic+, thus increasing the portfolio of services the centre offers and facilitating patient access to this technology. “Laser ablation is a minimally invasive technique with very good results that reduces the risk of complications and allows an earlier recovery than conventional surgery” explains Dr Joaquim Enseñat, head of the Neurosurgery Department at Hospital Clínica de Barcelona and barnaclinic+ professional.
“Laser ablation is a minimally invasive technique with very good results that reduces the risk of complications and allows an earlier recovery than conventional surgery”
Dr Joaquim Enseñat, head of the Neurosurgery Department at Hospital Clínica de Barcelona and barnaclinic+ professional
What is laser ablation for treating brain tumours and epilepsy?
Laser ablation for brain tumours and epilepsy consists of the introduction of a millimetric optical fibre that imitates laser light through a small incision of between 2 and 3 cm. “By means of a laser energy source and through these fibres it is possible to destroy the diseased tissue by reheating the diseased area”, explains Dr Pedro Roldán, a neurosurgeon at the hospital Clínic de Barcelona and barnaclinic+, who adds that the patient is monitored in real-time by magnetic resonance imaging to control the tissue being destroyed at all times.
“By means of a laser energy source and through these fibres it is possible to destroy the diseased tissue by reheating the diseased area”
Dr Pedro Roldán, a neurosurgeon at the hospital Clínic de Barcelona and barnaclinic+
The procedure takes approximately 2-3 hours and, once the operation is over, the patient returns to his or her room and within a short period of 24-48 hours can be discharged from the hospital. “This is one of the main advantages of this intervention, the rapid recovery of the patient. With conventional surgery, it can take between five and seven days. In addition, the return to work of these patients is also faster,” says Dr Joaquim Enseñat, who adds the importance of performing this type of intervention in centres with high technology that allows them to be very precise in the placement of the laser fibres.
Which patients are candidates for this laser technique?
There is a wide variety of patients who can benefit from laser ablation, and a particular study of each case is always necessary to see if this technique is the most appropriate. In general, the main candidates for laser ablation are those cases whose complexity, due to their proximity to delicate areas or depth, makes them too risky for conventional surgery. “This may be because the affected area is very close to an eloquent area, i.e. those with a high functional expressiveness, and therefore the operation may leave important sequelae,” says Dr Enseñat, who also points out that another reason is that the affected area is very deep and therefore it would be necessary to go through a lot of tissue to reach it.
Laser ablation for brain tumours and epilepsy is also a technique with certain limitations. When the lesion is larger than three or four centimetres or very irregular in shape, laser ablation may not be the best option. “However, it is also possible to combine different laser fibres to treat these types of lesions,” says Dr Enseñat. To which Dr Roldan adds: “Any case would be a candidate for study to assess the possibility of treatment using this technique”.
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Advantages of laser ablation over conventional neurosurgery
As laser ablation is a minimally invasive procedure, it has the inherent advantages of any operation in that it does not require a large incision. This translates mainly into a much faster recovery for the patient. But the technique has other advantages as well. “Laser ablation has far fewer complications than conventional surgery. Above all, the risk of infections, haemorrhages and infarctions is greatly reduced” says Dr Joaquín Enseñat, who also explains that the patient’s rapid recovery means that other complementary treatments are not delayed in the case of brain tumours, should they be necessary.
“Laser ablation has far fewer complications than conventional surgery. Above all, the risk of infections, haemorrhages and infarctions is greatly reduced”
Another advantage, also derived from the small incision required, is that patients do not have such significant aesthetic sequelae as with conventional surgery. “This is another point in favour of laser ablation, which also facilitates the person’s reincorporation into their social life” explains Dr Roldán.
Why have surgery at barnaclinic+?
Currently, laser ablation is not an operation that can be performed in just any centre, and to date very few centres can offer it. It requires an operating theatre with a high level of technology that allows the procedure to be carried out with maximum safety and efficiency. “There are few centres that have this technology, which also requires a high degree of specialisation on the part of the surgeons. Hospital Clínic and barnaclinic+ are now leading centres not only in Spain, but worldwide,” explains Dr Enseñat. Dr Pedro Roldán, for his part, highlights the latest generation Renishaw® surgical robot, and the intraoperative CT, “a tectology that guarantees the implantation of the fibre with submillimetric precision, which makes us one of the best technologically equipped centres in the world”.
“There are few centres that have this technology, which also requires a high degree of specialisation on the part of the surgeons. Hospital Clínic and barnaclinic+ are now leading centres not only in Spain, but worldwide”
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On the other hand, Dr Roldán also highlights the high level of the professionals at the centre, which is also backed by a history of more than one hundred years. “We have international professionals with more than proven experience, who are undoubtedly one of the main reasons for carrying out this procedure at barnaclínic+”.
“We have international professionals with more than proven experience, who are undoubtedly one of the main reasons for carrying out this procedure at barnaclínic+”
Dr Pedro Roldán