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https://www.readbyqxmd.com/read/28777037/applications-of-a-robotic-stereotactic-arm-for-pediatric-epilepsy-and-neurooncology-surgery
#1
Brandon A Miller, Afshin Salehi, David D Limbrick, Matthew D Smyth
OBJECTIVE The ROSA device is a robotic stereotactic arm that uses a laser system to register the patient's head or spine with MR or CT images. In this study, the authors analyze their experience with this system in pediatric neurosurgical applications and present selected cases that exemplify the usefulness of this system. METHODS The authors reviewed all cases that utilized the ROSA system at their institution. Patient demographics, pathology, complications, electrode placement, laser ablation, and biopsy accuracy were analyzed...
August 4, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28774708/epileptologist-s-view-laser-interstitial-thermal-ablation-for-treatment-of-temporal-lobe-epilepsy
#2
Joon Y Kang, Michael R Sperling
A procedure called laser interstitial thermal ablation has been utilized to treat drug resistant epilepsy. With this technique, a probe is stereotactically inserted into a target structure responsible for seizures, such as mesial temporal lobe, hypothalamic hamartoma, or a small malformation of cortical development, and the tip is then heated by application of laser energy to ablate structures adjacent to the probe tip. This procedure has the advantage of selectively targeting small lesions responsible for seizures, and is far less invasive than open surgery with shorter hospitalization, less pain, and rapid return to normal activities...
July 25, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28719087/mri-guided-stereotactic-neurosurgical-procedures-in-a-diagnostic-mri-suite-background-and-safe-practice-recommendations
#3
Paul S Larson, Jon T Willie, Sudhakar Vadivelu, Hooman Azmi-Ghadimi, Amy Nichols, Loretta Litz Fauerbach, Helen Boehm Johnson, Denise Graham
The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28699085/laser-interstitial-thermal-therapy-for-epilepsy
#4
REVIEW
Eric Prince, Shahin Hakimian, Andrew L Ko, Jeffrey G Ojemann, Michelle S Kim, John W Miller
MRI-guided laser interstitial thermal therapy (MgLiTT) uses a narrow diameter cannula to stereotactically target and heat deeper cerebral structures. This technique produces a precise lesion in the brain with great reliability because the localized tissue temperature change is monitored in real time. Because MgLiTT minimizes injury to surrounding brain, it appears to have a lower risk of affecting normal neurological function, and because it is done through a burr hole, there is less operative risk, less discomfort, and shorter hospitalizations...
September 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28665249/improved-operative-efficiency-using-a-real-time-mri-guided-stereotactic-platform-for-laser-amygdalohippocampotomy
#5
Allen L Ho, Eric S Sussman, Arjun V Pendharkar, Scheherazade Le, Alessandra Mantovani, Alaine C Keebaugh, David R Drover, Gerald A Grant, Max Wintermark, Casey H Halpern
OBJECTIVE MR-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive method for thermal destruction of benign or malignant tissue that has been used for selective amygdalohippocampal ablation for the treatment of temporal lobe epilepsy. The authors report their initial experience adopting a real-time MRI-guided stereotactic platform that allows for completion of the entire procedure in the MRI suite. METHODS Between October 2014 and May 2016, 17 patients with mesial temporal sclerosis were selected by a multidisciplinary epilepsy board to undergo a selective amygdalohippocampal ablation for temporal lobe epilepsy using MRgLITT...
June 30, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28591480/laser-interstitial-thermal-therapy-a-first-line-treatment-for-seizures-due-to-hypothalamic-hamartoma
#6
REVIEW
Victor X Du, Shashank V Gandhi, Harold L Rekate, Ashesh D Mehta
Successful treatment of hypothalamic hamartoma (HH) can result in the resolution of its sequelae including epilepsy and rage attacks. Risks and morbidity of open surgical management of this lesion have motivated the development of laser interstitial thermal therapy (LITT) as a less invasive treatment approach to the disease. Although overall morbidity and risk would appear to be lower, complications related to LITT therapy have been reported, and the longer-term follow-up that is now possible after initial experience helps address the question of whether LITT provides equivalent efficacy compared to other treatment options...
June 2017: Epilepsia
https://www.readbyqxmd.com/read/28580377/optimization-of-curvilinear-needle-trajectories-for-transforamenal-hippocampotomy
#7
David B Comber, E Bryn Pitt, Hunter B Gilbert, Matthew W Powelson, Emily Matijevich, Joseph S Neimat, Robert J Webster, Eric J Barth
BACKGROUND: The recent development of MRI-guided laser-induced thermal therapy (LITT) offers a minimally invasive alternative to craniotomies performed for tumor resection or for amygdalohippocampectomy to control seizure disorders. Current LITT therapies rely on linear stereotactic trajectories that mandate twist-drill entry into the skull and potentially long approaches traversing healthy brain. The use of robotically-driven, telescoping, curved needles has the potential to reduce procedure invasiveness by tailoring trajectories to the curved shape of the ablated structure and by enabling access through natural orifices...
February 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28521346/real-time-magnetic-resonance-imaging-guided-biopsy-using-smartframe%C3%A2-stereotaxis-in-the-setting-of-a-conventional-diagnostic-magnetic-resonance-imaging-suite
#8
Justin K Scheer, Thomas Hamelin, Leon Chang, Brian Lemkuil, Bob S Carter, Clark C Chen
BACKGROUND: Real-time magnetic resonance imaging (MRI) visualization during stereotactic needle biopsies affords several valuable benefits to the neurosurgeon, including the opportunity to visually confirm the biopsy site at the time of surgery. Until now, reported experiences with this technique have been limited to the setting of intraoperative MRI or dedicated procedural MRI suites with modified ventilation systems. OBJECTIVE: To describe our experience with 11 consecutive patients who underwent real-time MRI-guided biopsy performed using SmartFrame® stereotaxis (MRI Interventions, Irvine, California) in the setting of a conventional diagnostic MRI suite...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28490155/endoscopic-treatment-of-hypothalamic-hamartomas
#9
REVIEW
Kyu Won Shim, Eun Kyung Park, Dong-Seok Kim
Hypothalamic hamartoma (HH) is a benign indolent lesion despite the presentation of refractory epilepsy. Behavioral disturbances and endocrine problems are additional critical symptoms that arise along with HHs. Due to its nature of generating epileptiform discharge and spreading to cortical region, various management strategies have been proposed and combined. Surgical approaches with open craniotomy or endoscopy, stereotactic approaches with radiosurgery and gamma knife surgery or radiofrequency thermos-coagulation, and laser ablation have been introduced...
May 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28479523/lesion-optimization-for-laser-ablation-fluid-evacuation-prior-to-laser-induced-thermal-therapy
#10
Timothy Wong, Nitesh V Patel, Filipe Feiteiro, Shabbar F Danish, Simon Hanft
BACKGROUND: Magnetic resonance-guided laser-induced thermal therapy (MRgLITT) is a minimally invasive surgical procedure for ablating intracranial lesions. The presence of a fluid body can sequester thermal energy generated by the laser catheter, which compromises the performance of MRgLITT, resulting in suboptimal ablation of cystic lesions. We report our use of stereotactic fluid evacuation followed by MRgLITT in 2 patients with cystic brain tumors. This is the first report on lesion optimization by fluid aspiration before MRgLITT...
August 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28463619/letter-to-the-editor-stereotactic-laser-ablation-for-hypothalamic-hamartomas-after-srs-failure
#11
Nicholas J Brandmeir, Michael D Sather
No abstract text is available yet for this article.
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28419284/laser-thermal-ablation-for-metastases-failing-radiosurgery-a-multicentered-retrospective-study
#12
Tafadzwa L Chaunzwa, Di Deng, Eric C Leuthardt, Stephen B Tatter, Alireda M Mohammadi, Gene H Barnett, Veronica L Chiang
BACKGROUND: Radiosurgical failure following stereotactic radiosurgery for brain metastases can be attributed to tumor regrowth or radiation necrosis. MRI-guided laser thermal ablation (LTA) therapy has emerged as an option for treatment; however, previous literature demonstrates variable results across centers. OBJECTIVE: To assess the outcomes of LTA in the treatment of metastases failing radiosurgery across multiple centers and to determine if any treatment factors are predictive of outcome...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28415147/neurosurgical-laser-ablation-and-mr-thermometry-risks-of-multisite-workflow-pattern
#13
Paul S Larson, Sudhakar Vadivelu, Hooman Azmi-Ghadimi, Amy Nichols, Loretta Fauerbach, Helen Boehm Johnson
Neurosurgical laser ablation is a relatively new but rapidly growing application of stereotactic neurosurgery that allows neurosurgeons to treat many previously untreatable conditions with the added benefit of shorter hospitalizations and recovery times. The vast majority of these procedures, however, are performed using a multisite workflow pattern involving transport of the patient between the operating room (OR), the computed tomography (CT) suite, and the magnetic resonance imaging (MRI) suite, often necessitating patient transfer through public pathways and requiring multiple trips if laser fiber placement is not accurate...
April 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28362211/laser-interstitial-thermal-therapy-for-palliative-ablation-of-a-chordoma-metastasis-to-the-spine-case-report
#14
Brian J Williams, Patrick J Karas, Ganesh Rao, Laurence D Rhines, Claudio E Tatsui
The authors present the first report of laser interstitial thermal therapy (LITT) ablation of a recurrent chordoma metastasis to the cervical spine. This patient was a 75-year-old woman who was diagnosed and treated for a sacral chordoma, and then developed metastases to the lung and upper thoracic spine. Unfortunately she experienced symptomatic recurrence at the C-7 spinous process. She underwent an uncomplicated LITT to the lesion. The patient convalesced without incident and was discharged on postoperative Day 1...
June 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28096104/recent-developments-in-the-surgical-management-of-paediatric-epilepsy
#15
REVIEW
Vijay M Ravindra, Matthew T Sweney, Robert J Bollo
Among the 1% of children affected by epilepsy, failure of pharmacological therapy and early age of seizure onset can lead to worse long-term cognitive outcomes, mental health disorders and impaired functional status. Surgical management often improves functional and cognitive outcomes in children with medically refractory epilepsy, especially when seizure remission is achieved. However, surgery remains underused in children with drug-resistant epilepsy, creating a large treatment gap. Several recent innovations have led to considerable improvement in surgical technique, including the recent development of minimally invasive diagnostic and therapeutic techniques such as stereotactic EEG, transcranial magnetic stimulation, MRI-guided laser ablation, as well as novel paradigms of neurostimulation...
August 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27995127/stereotactic-laser-ablation-for-medically-intractable-epilepsy-the-next-generation-of-minimally-invasive-epilepsy-surgery
#16
REVIEW
Michael J LaRiviere, Robert E Gross
Epilepsy is a common, disabling illness that is refractory to medical treatment in approximately one-third of patients, particularly among those with mesial temporal lobe epilepsy. While standard open mesial temporal resection is effective, achieving seizure freedom in most patients, efforts to develop safer, minimally invasive techniques have been underway for over half a century. Stereotactic ablative techniques, in particular, radiofrequency (RF) ablation, were first developed in the 1960s, with refinements in the 1990s with the advent of modern computed tomography and magnetic resonance-based imaging...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27959970/magnetic-resonance-thermometry-guided-stereotactic-laser-ablation-of-cavernous-malformations-in-drug-resistant-epilepsy-imaging-and-clinical-results
#17
D Jay McCracken, Jon T Willie, Brad Fernald, Amit M Saindane, Daniel L Drane, Daniel L Barrow, Robert E Gross
BACKGROUND: Surgery is indicated for cerebral cavernous malformations (CCM) that cause medically refractory epilepsy. Real-time magnetic resonance thermography (MRT)-guided stereotactic laser ablation (SLA) is a minimally invasive approach to treating focal brain lesions. SLA of CCM has not previously been described. OBJECTIVE: To describe MRT-guided SLA, a novel approach to treating CCM-related epilepsy, with respect to feasibility, safety, imaging, and seizure control in 5 consecutive patients...
March 2016: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/27861324/laser-ablation-of-recurrent-malignant-gliomas-current-status-and-future-perspective
#18
Analiz Rodriguez, Stephen B Tatter
Recurrent malignant glioma continues to be a clinical challenge, and repeat surgery is an option in only select patients. Stereotactic laser ablation, a new minimally invasive technique, can be used as an alternative to surgery. We review the current literature on laser ablation for recurrent malignant gliomas as well as discuss practical and theoretical advantages and disadvantages of this emerging technique in comparison with repeat surgery or radiation. We also discuss the potential for laser ablation to augment adjuvant therapies, namely, chemotherapy, radiation, and immunotherapy...
December 2016: Neurosurgery
https://www.readbyqxmd.com/read/27861323/stereotactic-laser-interstitial-thermal-therapy-for-recurrent-high-grade-gliomas
#19
Ian Lee, Steven Kalkanis, Constantinos G Hadjipanayis
BACKGROUND: The value of maximal safe cytoreductive surgery in recurrent high-grade gliomas (HGGs) is gaining wider acceptance. However, patients may harbor recurrent tumors that may be difficult to access with open surgery. Laser interstitial thermal therapy (LITT) is emerging as a technique for treating a variety of brain pathologies, including primary and metastatic tumors, radiation necrosis, and epilepsy. OBJECTIVE: To review the role of LITT in the treatment of recurrent HGGs, for which current treatments have limited efficacy, and to discuss the possible role of LITT in the disruption of the blood-brain barrier to increase delivery of chemotherapy locoregionally...
December 2016: Neurosurgery
https://www.readbyqxmd.com/read/27861321/laser-interstitial-thermal-therapy-technology-physics-of-magnetic-resonance-imaging-thermometry-and-technical-considerations-for-proper-catheter-placement-during-magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy
#20
Nitesh V Patel, Matthew Mian, R Jason Stafford, Brian V Nahed, Jon T Willie, Robert E Gross, Shabbar F Danish
Laser-induced thermal therapy has become a powerful tool in the neurosurgical armamentarium. The physics of laser therapy are complex, but a sound understanding of this topic is clinically relevant, as many centers have incorporated it into their treatment algorithm, and educated patients are demanding consideration of its use for their disease. Laser ablation has been used for a wide array of intracranial lesions. Laser catheter placement is guided by stereotactic planning; however, as the procedure has popularized, the number of ways in which the catheter can be inserted has also increased...
December 2016: Neurosurgery
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