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The first 25 slides, exactly as they appear. The full deck has 65 content slides.
Neurosurgery
Neuroblate Laser Ablation of Intracranial Tumors
Built from Feldman — Neurosurgical Operative Atlas: Neuro-Oncology
What’s inside
7 sections · 65 slides
Overview
- What you will learn
- The big idea in one slide
How Laser Ablation Destroys a Tumor
From laser light to dead tumour cells
- What actually happens inside the tumour
- Two things decide how much tumour dies
- Heat does not spread evenly through the brain
- The balancing act of every ablation
- Why this was not possible until recently
- The approved systems
- The NeuroBlate system: the essentials
- The laser delivery probe
- Sapphire tip of the laser probe
- How the probe is built and moved
- Operating room layout for NeuroBlate ablation
Choosing the Right Patient
Who benefits, and who does not
- The main indications
- Tumours that are poor targets
- Combining biopsy with ablation
- Where these tumours sit
- Respect the fibre tracts
- Diffusion tensor imaging of critical fibre tracts
- Size, trajectories, and swelling
- When the standard hardware will not fit
Preoperative Preparation
Imaging, infection screening, and medication
- Consent and planning imaging
- Screening for infection risk
- Medications given at induction
- A note on steroids and anticonvulsants
The Operation Step by Step
Inside the intraoperative MRI suite
- How the workflow has evolved
- Positioning and registration
- Opening a path to the tumour
- The cranial minibolt
- Setting the bolt and calibrating depth
- The automated (robotic) probe driver
- Docking the probe and going remote
- Planning the target volume in M-vision software
- Three-plane temperature monitoring at the tip
- Delivering and watching the heat
- Real-time thermometry with thermal damage lines
- Reading the coloured damage lines (TDT)
- Finishing the procedure
After the Ablation
Expected changes, monitoring, and risks
- Postoperative management
- Reading the post-ablation MRI: three zones
- Why the tumour looks bigger first
- Complications to expect and counsel for
- Numbers worth remembering
Learning from Real Cases
When ablation shines and when to hold back
- Deep dominant-temporal glioblastoma before ablation
- After ablation: the three zones appear
- Case 1: newly diagnosed GBM in eloquent brain
- Right subcortical lesion hugging the motor tract
- Case 2: knowing when to say no
- Big irregular lesion, three trajectories
- Case 3: covering a big, awkward lesion
- Large operative-site haematoma after ablation
- Case 4: a delayed haemorrhage
- Three things to take away
- Conclusion and future directions
- Why are high-dose steroids routinely continued after a laser ablation?
- References (1/2)
- References (2/2)
- Neurosurgical Operative Atlas: Neuro-Oncology