Specialist neurosurgery · UK
Laser interstitial thermal therapy (LITT) — MRI-guided ablation of deep brain lesions.
A minimally invasive alternative to open craniotomy for deep or eloquent brain lesions — a 3–4 mm burr hole, a laser fibre, and real-time MRI thermometry. Delivered in a small number of UK specialist centres.
Why patients choose us
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A specialist neurosurgical centre, named up front
LITT is a specialist service in a small number of UK centres — King’s College Hospital, National Hospital Queen Square (UCLH), Great Ormond Street for children. We tell you which team is treating you, and why.
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The right lesion, the right tool
LITT suits deep or eloquent lesions that open surgery cannot safely reach. If a keyhole craniotomy or Gamma Knife is a better fit, we say so before you commit.
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Independent, and free
We are paid by no clinic or device manufacturer, so the recommendation is impartial and costs you nothing.
Routes and indicative cost
LITT in the UK is a specialist NHS service.
Almost all UK LITT is delivered through NHS specialist neurosurgical centres. A small number of cases are arranged privately by direct agreement with those centres.
In short
LITT in the UK: NHS specialist centres, one to two nights in hospital, back to office work in two to four weeks.
| Procedure | Route / indicative cost | Theatre time | Hospital stay |
|---|---|---|---|
| LITT — single deep tumour or metastasis | NHS-funded (specialist centre) | 2–4 h in theatre | 1–2 day stay |
| LITT — radiation necrosis | NHS-funded (specialist centre) | 2–4 h in theatre | 1–2 day stay |
| LITT — mesial temporal / epilepsy focus | NHS-funded (specialist centre) | 3–4 h in theatre | 1–2 day stay |
| LITT — hypothalamic hamartoma (paediatric) | NHS-funded (GOSH / specialist) | 3–4 h in theatre | 2–3 day stay |
| Second-opinion consultation (neurosurgery) | £300–£600 | 30–45 min | Same visit |
| Imaging review only | £250–£450 | 30 min | Same visit |
Because LITT relies on intra-operative MRI thermometry and specialist consumables, it is not a procedure you will find on a standard private price list. We help you understand the NHS pathway, when a private route is possible, and which centre fits your case.
The problem
The right modality for the right lesion — not just the one on offer.
LITT is an emerging modality, unevenly available in the UK. It is superb for certain deep lesions and unnecessary for others. Getting it right means comparing it honestly with open surgery, radiosurgery and medical management.
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Told a lesion is inoperable?
Deep thalamic, insular and brainstem lesions once ruled out for open surgery can sometimes be treated with LITT.
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Radiation necrosis after SRS?
A symptomatic area of necrosis that steroids cannot control is one of the clearest indications for LITT.
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Weighing epilepsy surgery?
LITT of the mesial temporal lobe is a smaller-footprint alternative to open temporal lobectomy — worth putting on the table with your epilepsy team.
The journey
From enquiry to follow-up MRI — what happens, in order.
One point of contact from your first message through MDT review, procedure and driving guidance.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
In theatre and MRI
Phase 3 · After
Concierge, back on
- 01
Before
You send us the imaging
A short, confidential form and the most recent MRI. Diagnosis, previous treatment, current symptoms.
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Before
We come back with a recommendation
Within one working day: whether LITT is the right modality, which specialist centre fits, an indication of NHS vs private route, and any alternatives worth considering.
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Before
MDT review and planning
The neuro-oncology or epilepsy MDT reviews the case. Stereotactic planning MRI is arranged and the trajectory is designed to avoid vessels and eloquent tracts.
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On the day
Admission and anaesthetic
Admission on the morning of surgery. General anaesthetic. Stereotactic frame or frameless navigation registration.
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On the day
The ablation itself
A 3–4 mm burr hole, laser fibre placed to the target, then transfer to MRI. Real-time MR thermometry monitors temperature at critical structures during a controlled 10–30 minute ablation per lesion.
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On the day
HDU overnight
Fibre out, skin sutured, one small dressing. High-dependency observation overnight, on a short dexamethasone taper and anti-seizure cover.
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After
Discharge and review
Home in one to two days for most patients. Back to office work in two to four weeks. DVLA driving rules apply — usually a four-week minimum, longer if there is any seizure history. Follow-up MRI in the neuro-oncology or epilepsy clinic.
Typical end-to-end: 4–8 weeks from referral to procedure. Return to office work: 2–4 weeks.
When it helps
When LITT is the right step.
The situations we see most, and the one red flag that means an emergency rather than an outpatient referral.
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Deep-seated brain tumour
Thalamic, insular, deep temporal or brainstem lesions where open resection carries unacceptable risk — including recurrent glioma or a solitary brain metastasis.
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Radiation necrosis after SRS or RT
A symptomatic area of necrosis after Gamma Knife, CyberKnife or fractionated radiotherapy — usually for a treated brain metastasis — that steroids cannot control.
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Mesial temporal sclerosis (epilepsy)
Drug-resistant temporal lobe epilepsy with a clear hippocampal focus — an alternative to open anterior temporal lobectomy, with a smaller footprint on memory.
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Hypothalamic hamartoma
Gelastic (laughing) seizures from a hypothalamic hamartoma — LITT is now a first-line surgical option in specialist paediatric and adult centres.
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Focal cortical dysplasia
A small, well-defined dysplasia in a deep or eloquent location where open resection would risk deficit.
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Recurrent GBM after previous surgery
A small, deep recurrence of glioblastoma or high-grade glioma that has come back in an area the open route cannot revisit safely.
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Select cavernous malformations
A minority of deep or eloquent cavernomas causing seizures or repeated bleeds may be candidates for LITT rather than open resection.
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Red flag: rapid new neurological deficit
A sudden new weakness, severe headache with vomiting, or reduced consciousness is an emergency — A&E the same day, not a clinic booking.
Procedure options
LITT is not one procedure — it is a family.
Platforms, trajectory methods and indications differ. What matters is which combination is used for your specific lesion.
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Visualase (Medtronic) LITT
1064 nm diode laser with a 15 mm active-length cooled fibre — the most widely used platform in UK centres.
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NeuroBlate (Monteris) LITT
Side-firing and diffusing tip options that let the surgeon shape the ablation in irregular lesions.
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Frame-based stereotactic LITT
A rigid stereotactic frame gives sub-millimetre trajectory accuracy — the classic route in adult neurosurgery.
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Frameless (robotic) LITT
Neuronavigation or a surgical robot (ROSA / Neuromate) delivers the trajectory without a head frame — often preferred in paediatric cases.
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Staged multi-lesion LITT
Two or three separate targets treated in the same anaesthetic, or in a staged sequence a few weeks apart.
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LITT for epilepsy
Mesial temporal, hypothalamic hamartoma or a small dysplasia — planning is done jointly with the epilepsy team.
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LITT for tumour or necrosis
A recurrent metastasis, deep glioma or symptomatic radiation necrosis — planning is done jointly with neuro-oncology.
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Second-opinion review
An honest review of your imaging and case notes — whether LITT, keyhole craniotomy, Gamma Knife or continued medical management fits best.
Our vetted UK network
A small panel of neurosurgeons, we picked them.
Consultant neurosurgeons at the UK centres that offer LITT — King’s College Hospital, National Hospital for Neurology and Neurosurgery (Queen Square), and Great Ormond Street for children. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every neurosurgeon in our network.
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A named neurosurgeon with a subspecialty LITT practice, not a generalist
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Intra-operative MRI thermometry — the safety net that makes LITT viable
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Joint neuro-oncology or epilepsy MDT input for every case
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Access to a paediatric LITT pathway (Great Ormond Street) when needed
Safety and recovery
What to expect afterwards — honestly.
LITT trades the bone flap and long recovery of open surgery for a single burr hole and one to two days in hospital. The trade-offs — bleeding risk, transient and permanent deficit — are small but real.
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General anaesthetic and one small burr hole
You are asleep. The only skin wound is a 3–4 mm burr hole in the scalp, closed with a single suture and a small dressing.
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Real-time MR thermometry
The MRI shows the temperature at the target and at critical structures throughout the ablation — the ablation stops the moment a safety threshold is approached.
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Haemorrhage — uncommon, mostly minor
A small bleed along the fibre track happens in roughly 2–5% of cases; most are picked up on the post-procedure scan without causing symptoms.
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Transient neurological deficit
A short-lived weakness, speech or visual change from swelling at the ablation site is not unusual and usually settles within days to weeks.
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Permanent neurological deficit
Around 2–5% of patients have a lasting deficit — mostly small, and directly related to the location of the lesion being treated.
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Post-procedure seizures
Anti-seizure medication is given routinely around the procedure. A short-term rise in seizure frequency can occur before things settle.
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Oedema and steroid taper
A brief course of dexamethasone controls the swelling that follows any brain ablation. Rarely, symptomatic oedema needs a longer taper.
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Rare complications
Infection at the burr hole, CSF leak and hydrocephalus are all uncommon. Incomplete ablation of a tumour is possible and may need a re-treatment.
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Red flags after discharge
New severe headache with vomiting, a new weakness or speech problem, a fit, fever or wound leak — call the specialist team or A&E the same day.
Reading your operation note
Your LITT operation note in four parts. Read the last one first.
Whichever platform and centre delivered your ablation, the note the neurosurgeon sends you keeps to the same shape.
A quiet reminder
Neurosurgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your follow-up, just ask.
- 01 Header
Diagnosis and lesion treated
The lesion(s) targeted, why LITT was chosen over the alternatives, and which platform (Visualase or NeuroBlate) was used.
- 02 Technique
Trajectory and ablation delivered
Frame vs frameless, the trajectory chosen, the number of laser doses and the MR thermometry maps that confirm the ablation covered the target.
- 03 Findings
Coverage and any events
How much of the target was ablated, any small track bleed on the post-procedure MRI, and any transient neurological signs on waking.
- 04 Impression
Follow-up, driving and next scan
Read this first: steroid and anti-seizure plan, when it is safe to drive under DVLA rules, and when the follow-up MRI is scheduled.
Recognised by major UK insurers
LITT itself is overwhelmingly NHS-funded in the UK. Insurers may fund consultations, second opinions and imaging review with the specialist teams — we confirm cover before booking.
Frequently asked
Everything we get asked about LITT.
Straight answers on what LITT is, where it is done, how it compares with craniotomy and Gamma Knife, and what recovery looks like.
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What is laser interstitial thermal therapy (LITT)?
LITT is a minimally invasive neurosurgical procedure in which a thin laser fibre is placed into a brain lesion through a 3–4 mm burr hole and used to heat and destroy the tissue from the inside. Real-time MRI thermometry monitors the temperature at the target and at nearby critical structures throughout, which is what makes ablation of deep or eloquent lesions viable.
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Where is LITT available in the UK?
LITT is a specialist service in a small number of UK centres — King’s College Hospital and the National Hospital for Neurology and Neurosurgery (Queen Square, UCLH) for adults, and Great Ormond Street for children. It is not offered in every neurosurgical unit, so most patients are referred in from elsewhere.
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Which conditions can be treated with LITT?
The main indications are deep-seated brain tumours (recurrent glioma, brain metastases), symptomatic radiation necrosis after Gamma Knife or fractionated radiotherapy, drug-resistant mesial temporal lobe epilepsy, hypothalamic hamartoma causing gelastic seizures, small focal cortical dysplasias in eloquent locations, and select deep cavernous malformations.
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How does LITT compare with an open craniotomy?
LITT is much less invasive — a single burr hole rather than a bone flap, a shorter hospital stay, and a quicker return to normal activity. The trade-off is that it works best for small, well-defined lesions, and for some larger or more accessible tumours an open resection still gives better tumour control.
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How does LITT for epilepsy compare with anterior temporal lobectomy?
For mesial temporal sclerosis, published series report seizure freedom of around 60–70% at twelve months after LITT, modestly lower than the 70–80% typically quoted for open anterior temporal lobectomy. The advantage of LITT is a smaller impact on verbal memory and a much quicker recovery, which is why many epilepsy centres now discuss both options.
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How does LITT compare with Gamma Knife radiosurgery?
Gamma Knife is non-invasive — no incision at all — and is often the first choice for small brain metastases. LITT is preferred when a lesion has already been irradiated and needs a different modality (for example, biopsy-proven radiation necrosis, or a recurrence within a previously treated field) or when a tissue diagnosis is needed at the same time.
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What are the risks of LITT?
The main risks are a small bleed along the fibre track (roughly 2–5%, most without symptoms), a transient neurological deficit that usually settles, and a permanent deficit in around 2–5% — the level of risk depends on how eloquent the treated area is. Post-procedure oedema managed with steroids, short-term seizures and, rarely, infection or CSF leak are the other things to know about.
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Is LITT available privately in the UK, and what does it cost?
LITT is overwhelmingly delivered through NHS specialist centres in the UK — the equipment, MR thermometry and MDT infrastructure needed are concentrated there. A small number of cases are funded privately by arrangement with those same centres, but a straight private price list is not the norm. We help you understand which route applies to your case.
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How long is the recovery, and when can I drive?
Most patients are home in one to two days, back to office work in two to four weeks, and back to full activity by six to eight weeks. Driving is governed by DVLA rules — typically a minimum of four weeks off driving after cranial surgery, and much longer (often a year or more) if there is a seizure history. Your neurosurgical team confirms the exact rule for your case.
Related treatments
Looking for something else?
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Keyhole craniotomy
A minimally invasive open route for lesions LITT cannot reach.
Learn more -
Craniotomy
Standard open resection for larger or more accessible brain lesions.
Learn more -
Gamma Knife radiosurgery
Non-invasive stereotactic radiosurgery — often the first choice for small metastases.
Learn more -
All tests & procedures
Every test, scan and procedure we arrange.
Learn more
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