Laser Interstitial Thermal Therapy

Laser interstitial thermal therapy (LITT) is a minimally invasive brain procedure that uses MRI-guided laser heat to treat conditions like brain tumors, epilepsy and radiation damage.

During LITT, a surgeon places a small tube through a tiny opening in your skull and uses focused heat to destroy unhealthy tissue. The laser targets the problem area while helping protect nearby healthy brain tissue.

Because the incision is very small, recovery is often faster and easier than with traditional open brain surgery.

Healthcare providers may recommend LITT when a condition is difficult to reach with standard surgery or when open surgery may be too risky. Your care team will talk with you about whether this procedure is a good option for your situation.

What does LITT surgery treat?

Laser interstitial thermal therapy may treat or manage several conditions, including:

• Brain tumors, like gliomas and brain metastases
• Radiation necrosis or radiation-related tissue damage after cancer treatment
• Epilepsy, especially when medications don’t fully control seizures
• Recurrent or hard-to-treat conditions

How does laser interstitial thermal therapy work?

LITT works by using heat to destroy a small area of unhealthy brain tissue.

During the procedure, your surgeon places a thin tube (catheter) into your brain. A laser sends energy through the tube, creating heat inside the target tissue.

If the area gets hot enough, the heat destroys the cells. The goal is to treat the problem area while protecting nearby healthy brain tissue.

Right after treatment, the area may swell temporarily. Over time, the treated tissue usually shrinks as your body heals.

How should I prepare for LITT?

To prepare for a LITT procedure, your care team will guide you through a few simple steps:

• Medical check and imaging: You’ll have exams and scans (like an MRI) to plan the procedure.
• Medication changes: Your surgeon may adjust or stop certain medicines, like blood thinners.
• Fasting before surgery: You won’t eat or drink for several hours before the procedure.

Your healthcare team will also review the risks, benefits, and what to expect before, during and after surgery.

What happens during LITT?

Here’s what you might expect during LITT:

1. Planning: Your care team uses MRI (and sometimes CT scans) to map the treatment area in your brain.
2. Getting anesthesia: You’ll receive general anesthesia. This is a medication that puts you to sleep so you won’t feel any pain.
3. Positioning your head: In the operating room, your care team will carefully position your head so your surgeon can guide the laser with high accuracy.
4. Making a small opening: Your surgeon makes a small cut (incision) in your scalp and a tiny hole in your skull.
5. Placing the laser probe: Your surgeon inserts a thin tube (laser probe) through the hole and guides it to the target area.
6. Checking placement with MRI: An MRI confirms that the probe is in the correct spot.
7. Heating the tissue: The laser turns on and heats the abnormal tissue. Your team watches this in real time on an MRI to control the treatment.
8. Adjusting if needed: Your surgeon may move the probe slightly to treat the full area safely.
9. Protecting healthy tissue: The system continuously monitors temperature and stops if heat gets too close to healthy brain areas.
10. Finishing the procedure: Your surgeon removes the probe and closes the small incision.
11. Recovery and monitoring: You’ll stay in the hospital (usually for one to two days) to make sure you recover safely.

How long does laser interstitial thermal therapy take?

LITT usually takes about two to five hours from start to finish. The exact time can vary based on the size and shape of the treatment area and how many times your surgeon needs to adjust the laser during the procedure. Your care team will give you the best time estimate based on your situation.

Laser interstitial thermal therapy benefits

LITT offers several benefits, including:

• It’s minimally invasive and offers a faster recovery time than open surgery.
• It’s highly precise and a good option for hard-to-reach areas.
• It destroys abnormal tissue directly.
• It helps manage certain underlying conditions, like epilepsy and brain tumors, when other treatments don’t work.

Laser interstitial thermal therapy side effects

LITT is generally safe, but like any procedure, it can have side effects. While uncommon, these may include:

• Neurologic symptoms, like weakness, speech problems or changes in sensation (often temporary, but sometimes long-lasting)
• Brain swelling (can cause headaches or temporary worsening of symptoms)
• Seizures (new or worsening of existing ones)
• Bleeding (usually small, but can sometimes be more serious)
• Infection or other complications, like fluid buildup

There’s also a small risk of injury to nearby healthy brain tissue or a slight misplacement of the probe. Your care team monitors you closely to help manage these risks.

What happens after LITT?

After the procedure, you’ll usually stay in the hospital for about a day so your care team can monitor you. It’s normal to feel tired, have a headache or mild pain, or feel nauseated at first.

In the days and weeks after surgery, you may notice temporary symptoms from brain swelling. Depending on the location treated, these symptoms can include weakness, trouble speaking or seizures. This might feel concerning, but it’s often expected and may improve as the swelling goes down.

Your provider may prescribe medications, like steroids or anti-seizure medications, to help manage symptoms during recovery.

Over time, the treated area in your brain will heal and go back to its proper size. LITT may not cure the condition, but it may help you manage it or reduce symptoms. It may slow disease progression. Some changes get better quickly, while others take longer.

What is the recovery time for LITT?

Recovery from an LITT procedure is usually shorter than recovery after open surgery. Most people go home in a couple of days. You may start feeling better in a few days to weeks. Full recovery and healing can take weeks to months, depending on your condition.

Your recovery can vary based on what was treated and where it’s located in your brain. Your care team will follow you closely to make sure you’re healing safely.