Neurosurgeon, Mr Matthew Gutman

Victorian patients with limited treatment options for drug-resistant epilepsy, primary brain tumours and other brain conditions now have access to life-changing surgery at Cabrini Health following the introduction of a laser beam surgical technique new to Victorian private hospitals.

Cabrini Malvern is the first Victorian private hospital to offer Laser Interstitial Thermal Therapy (LITT) – a minimally-invasive surgical technique that uses a laser beam to reach deep into the brain through a hole no bigger than a fingertip.

The establishment of Cabrini Health’s Laser Interstitial Thermal Therapy (LITT) program follows the successful roll out of a LITT program at The Alfred hospital last year. It offers a surgical option for patients who may have previously been told their condition was inoperable.

LITT uses heat from MRI-guided laser beams to destroy abnormal brain tissue through a small hole in the skull, offering an alternative to traditional open brain surgery (craniotomy), with less pain and faster recovery times for suitable patients.

The procedure is most commonly used to treat epilepsy, brain tumours, radiation necrosis and brain metastasis, Cabrini neurosurgeon Mr Matthew Gutman said.

“There are patients who’ve been told they are inoperable who now have another treatment option and, in many cases, a cure for their condition,” he said.

“For example, for patients with drug-resistant epilepsy, where seizures persist despite multiple medications, LITT offers the prospect of a cure. These are people who’ve had uncontrolled epilepsy, often their whole lives. They come in, have the procedure, and then go home in the next day or so, and eventually, we can even take them off their medication.”

A traditional craniotomy involves making a large incision and removing sections of the skull, but with LITT, surgeons drill a tiny pilot burr hole, before inserting a fine laser fibre with advanced stereotactic precision to the targeted area of the brain, guided in real time using MRI imaging.

The laser, once at the targeted site, is activated, and an MRI-guided ablation is performed to destroy the pathological area, whether it be a brain tumour or the specific area of the brain where epileptic seizures originate.

LITT is used selectively at Cabrini Health for cases where traditional surgery cannot safely reach the affected area, or where it would carry a higher risk of damage to critical functions.
“We’re currently using the LITT for cases that are not safe for resection with a traditional craniotomy,” Mr Gutman said.

“We can essentially put the laser fibre anywhere in the brain safely and treat areas of the brain which were previously considered inoperable. And patients are usually ready to go home within 48 hours.”

Performing the LITT procedure using an MRI is vital to the delivery of this intricate procedure, Cabrini Chief MRI Technologist Jacinda Cadman said.

“MRI is used during the LITT procedure to provide real-time intraoperative guidance for localisation, mapping, and temperature monitoring, to ensure precise destruction of a target lesion and to preserve healthy tissue,” she said.

“Cabrini Malvern has three state-of-the-art MRI scanners, which means we can deliver complex procedures like LITT and offer high-quality, comprehensive MRI services for our community.”
The arrival of the LITT program is part of a broader expansion of surgical care at Cabrini. The Next Era redevelopment includes the addition of four new operating theatres, increasing the hospital’s capacity to treat more patients, including those requiring specialised procedures like LITT, when and where they need it.

“This is an exciting time for us,” Cabrini Health Chief Executive Sue Williams said. “We’re growing, innovating and extending our capabilities across a number of our key specialties, including neurosurgery.

“Our LITT program is one of our new programs that offers our patients hope, and positions Cabrini Health as a leading healthcare provider in neurosurgery.”

Visit Mr Gutman’s Cabrini Find A Doctor page for referral information.