LITT histoire et principes d une invention française
Seance of wednesday 06 march 2024 (Intérêt de la thermothérapie laser en Neurochirurgie)
DOI number : 10.26299/amhj-0807/emem.2024.08.01
Abstract
Laser-induced interstitial thermal therapy (LITT) is a minimally invasive surgical technique that uses heat generated by laser light to destroy brain lesions or structures by coagulation, with real-time MRI temperature monitoring. This technique proved its effectiveness and safety in the treatment of brain metastases for the first time in the world in 2006 (Pr Carpentier) in France, and since then more than 2,500 patients have been treated in the USA, particularly for lesions responsible for drug-resistant epilepsy. The first stage of the procedure is that of conventional stereotactic neurosurgery, which consists of precisely positioning the laser probe within the target structure.
LITT benefits from innovations in the operating theatre in terms of the safety and precision of probe placement, in particular through the use of robotics and 3D surgical control using a flat-sensor scanner. The second stage is carried out in the MRI machine, which enables cerebral thermal mapping to be carried out in real time. The ablation is then adapted to the size of the lesion and its functional environment. Real-time thermal mapping means that the procedure can be stopped automatically if the temperature that could cause a lesion exceeds the contours of the lesion to be treated. The predictive algorithm makes it possible to visualise the ablation that will result from the procedure. When the algorithm predicts a sufficient lesion, control MRI sequences are performed to ensure that the lesion is complete.
LITT is therefore emerging as a new surgical alternative for the treatment of the many ontological and functional brain pathologies currently present in m académie nationale de chirurgie.
LITT benefits from innovations in the operating theatre in terms of the safety and precision of probe placement, in particular through the use of robotics and 3D surgical control using a flat-sensor scanner. The second stage is carried out in the MRI machine, which enables cerebral thermal mapping to be carried out in real time. The ablation is then adapted to the size of the lesion and its functional environment. Real-time thermal mapping means that the procedure can be stopped automatically if the temperature that could cause a lesion exceeds the contours of the lesion to be treated. The predictive algorithm makes it possible to visualise the ablation that will result from the procedure. When the algorithm predicts a sufficient lesion, control MRI sequences are performed to ensure that the lesion is complete.
LITT is therefore emerging as a new surgical alternative for the treatment of the many ontological and functional brain pathologies currently present in m académie nationale de chirurgie.