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Visualase Minimally Invasive Surgery

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MIAMI CHILDREN’S HOSPITAL BRAIN INSTITUTE IS REGION’S FIRST IN USING MINIMALLY INVASIVE TECHNIQUE FOR EPILEPSY SURGERY IN CHILDREN
 
Epilepsy specialists at Miami Children’s Hospital are the first in the Southeast--and the second in the nation-- to offer minimally invasive laser surgery for children with seizures that don’t respond to anticonvulsant medications.
 
At a press conference on April 17, Dr. John Ragheb, director of Neurosurgery and Dr. Ian Miller, director of Neuroinformatics, described the procedure and its impact.  12-year-old Jessie Fernandez was the first patient at MCH to undergo the Visualase procedure in May of 2011. She has not had any seizures since.
 
To date, three patients have undergone the new treatment at Miami Children’s, including one child who came from out of state for the procedure. Among these children, the longest hospital stay was three days, compared with a seven to 10-day stay required for conventional surgery.

The Visualase system works by placing a laser probe at the surgical site using stereotactic, 3D-computer guidance in the operating room. The patient is then moved to the MRI scanner where the laser removes the target brain tissue using heat under continuous MRI monitoring. This allows a very precise region of tissue to be treated and minimizes risk of injury to other parts of the brain.

This method, as compared to traditional brain surgery for epilepsy, allows for a very small incision (so that very little hair needs to be removed), less postoperative pain, reduced risk of infection, faster recovery time and no need for removing portions of the skull, which reduces the chance of jaw problems later on.
 
Dr. Miller expressed optimism about the technology. “This is one of the newest tools in our toolbox to help children with epilepsy. It is perfectly suited for small, well-defined lesions in the brain that cause seizure activity,” he noted. He observed that there are many causes of epilepsy in children and that “this therapy is a particularly good fit for conditions such as cortical dysplasia, hypothalamic hamartoma and tuberous sclerosis.”