GAMMA KNIFE  RADIOSURGERY

 Gamma Knife (Surgery whithout scalpel) 

It is the administration of a high radiation dose, given in a single session, to a small and critically located intracranial volume, without the opening of the skull. (Definition of stereotactical radiosurgery by Lars Leksell, 1951).

The Leksell Gamma Knife was developed by Professor Lars Leksell of the Karolinska Institute of Stockholm, Sweden, along with biophysician Professor Börje Larsson. Leksell discovered that by administering a unique dose of radiation, it was possible to successfully destroy almost any deeply rooted brain structure, without the risk of hemorrhage or infection. He called this stereotactical technique "radiosurgery" and defined it as the administration of a unique high dose of radiation to a small and critically located intracranial volume with no need of the opening of the skull. The first Gamma Knife that used cobalt sources 60 was constructed and installed in Stockholm in the year 1967 and it has later expanded in such a way that nowadays more than 180 units in the world are working. The benefits of the Leksell Gamma Knife have an impact on all those interested in it: doctors, patients, hospitals and society. These benefits derive from its unique, non-invasive nature, its minimum requirements of admission, its accessible cost and its impressive long term results .

 The Principle

The Leksell Gamma Knife gives form to the radiation emitted by 201 cobalt-60 sources and it focuses through the orifices of the helmet collimator towards precise targets located within the brain. This precise collimation, along with their exact submillimetric location, is combined to produce a precise field of defined and extremely well located radiation. At this point called "Focal Point", site of cross-section of multiple and fine beams of radiation, the gamma rays reach sufficient intensity so as to damage the tissue located within the "white volume" in a prescribed dose . The steep fall of the dose in the periphery of the "target" is so that the radiation absorbed by the surrounding tissue is minimal and so is its effect Gamma Knife has few mobile parts, non-active during the treatment, thus providing greater precision, security and trustworthiness to the procedure.

 Cost-effectiviness

In the Gamma Knife surgery, in comparison to a conventional brain surgery, the costs are reduced to 20-30% according to publications available. As a result, it has become more accessible and more and more attractive for patients, doctors and administrators of health. In many indications, the rate of success is superior to that of the conventional methods, for example in certain vascular malformations and tumors.

 Indications of Gamma Knife :

Panorama of cases treated in the world to December 1999 (more than 130,000):

▪ benign Tumors (36%): meningiomas, neurinomas, tumors of hipophysis, others.

▪ vascular malformations(33%).

▪ malignant tumors (29%): metathesis tumors, glooms, tumors of head and neck, others.

▪ functional alterations (10%): trigemin neuralgia, epilepsy, hamartomas hipotalamic, abnormal movements, untreatable pain, others.

▪ Ophthalmopathies (1%): uveal melanomas , degeneration to spot, thyroid ophthalmopathy.

 Clinical Advice

Every time, a higher number of clinical indications is dealt with Leksell Gamma Knife. The publications approximately indicate rates of control in metastasic tumors of until 90% and rates of total obliteration for artherovenous malformations of 80%. The excellent results, together with low mortality rate , have made of Gamma Knife the first therapeutic option for a higher number of patients every time. With Gamma Knife surgeons can treat injuries that are located near critical structures or in patients with an increased risk in conventional surgery.

 The procedure with Gamma Knife

The surgery with Gamma Knife is simple and consists of four basic phases: fixation of the frame, accomplishment of localizing images, computerized planning of the treatment and the treatment. Itself.. Only local anesthesia is required and a smooth sedation during the positioning of the frame; only the children receive general anesthesia. The patient remains conscious throughout the procedure and can communicate with the surgical team, which controls him during such procedure through a video system. Usually, the patient can return to his pre-operational lifestyle the day after the surgery.

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