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Specialist neurosurgery · UK

Neurosurgical laser ablation, for lesions the scalpel cannot safely reach.

MRI-guided laser interstitial thermal therapy (LITT) delivered through a 3 mm burr hole, at a UK specialist centre - for drug-resistant temporal lobe epilepsy, hypothalamic hamartoma, deep glioma, small metastases and radiation necrosis.

The LITT technology overview
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private LITT costs in the UK.

Indicative ranges across our partner specialist centres.

In short

£28,000–£48,000, home in 2–3 days.

Procedure Indicative range
Consultant neurosurgical opinion £300–£500
Video-EEG monitoring (5-day inpatient) £8,000–£14,000
3T MRI + MRS + DTI tractography £1,400–£2,400
MRI-guided LITT (Visualase or NeuroBlate) £28,000–£48,000
Combined LITT + stereotactic biopsy £32,000–£55,000
MDT review and second opinion £500–£900

Prices vary by centre, by which laser platform is used (Visualase or NeuroBlate), by whether a stereotactic biopsy is combined with the ablation, and by length of HDU stay.

The problem

The right centre, the right work-up, the right target.

LITT is only offered by a handful of UK neurosurgical units, and only after a formal MDT. The bottleneck is not the laser - it is getting to the right team, with the right imaging and neurophysiology, before the plan is drawn.

  • Not sure LITT is even an option?

    Some lesions are LITT-appropriate, most are not. We get an MDT opinion before you commit to travel or self-pay.

  • Worried about deep-brain surgery?

    A 3 mm burr hole and MR thermometry replace a large craniotomy - with HDU for 24 hours and home in 2–3 days.

  • Want it done properly?

    A named neurosurgeon at a specialist centre with formal LITT case volume - not a first-in-programme case.

When it helps

When neurosurgical laser ablation is the right step.

The core indications a UK epilepsy or neuro-oncology MDT will consider for LITT - plus the red flag that means an emergency rather than an appointment.

  • Mesial temporal sclerosis (MTS)

    Drug-resistant temporal lobe epilepsy with MRI-confirmed hippocampal sclerosis - the best-studied LITT indication.

  • Hypothalamic hamartoma

    A deep midline lesion causing gelastic seizures and precocious puberty - historically very hard to reach with open surgery.

  • Deep-seated glioma

    Small thalamic, insular or brainstem tumours where open resection carries unacceptable deficit risk.

  • Small brain metastases

    Selected small mets (usually under 3 cm), particularly in eloquent or deep locations, or after prior SRS.

  • Radiation necrosis

    Symptomatic post-SRS necrosis where steroids and bevacizumab have failed - LITT gives a mechanical answer.

  • Selected cavernomas

    Deep-seated symptomatic cavernomas in patients who are not candidates for microsurgical resection.

  • Dominant-hemisphere temporal epilepsy

    LITT preserves verbal memory better than open anterior temporal lobectomy - often decisive on the dominant side.

  • Red flag: acute neurological decline

    New rapid weakness, seizures out of control, or reduced consciousness is an emergency - A&E, not a clinic booking.

Systems & options

The kit that makes LITT possible.

What the two commonly-used laser platforms and the main stereotactic delivery systems actually do - plus how they get combined. For the underlying technology in more depth see our LITT overview.

  • Visualase (Medtronic)

    980 nm diode laser with side- or end-firing diffusers, MR thermometry and automatic safety shut-offs - the most-used platform in UK epilepsy LITT.

  • NeuroBlate (Monteris)

    1064 nm Nd:YAG laser with a directional side-firing probe and gas-cooled catheter - often chosen for larger or irregular tumour ablations.

  • ROSA robotic stereotaxy

    Robotic arm for sub-millimetre trajectory delivery - used for both LITT and stereo-EEG electrode placement at several UK centres.

  • Neuromate robotic stereotaxy

    A UK-designed robotic system (Renishaw) used for stereotactic planning at units including King’s and GOSH.

  • Frame-based (Leksell)

    The classical stereotactic frame - still used where sub-millimetre rigidity outweighs the discomfort of frame placement.

  • Frameless with Stealth navigation

    Optical or electromagnetic tracking without a rigid frame - quicker set-up, favoured for some paediatric and adult cases.

  • Combined biopsy + LITT

    A stereotactic biopsy through the same trajectory before ablation - one anaesthetic, tissue diagnosis and treatment together.

  • LITT after failed SRS

    For radiation necrosis or radioresistant recurrence - LITT gives a mechanical answer where further radiation is unsafe.

Safety and outcomes

What to expect afterwards - honestly.

LITT is a specialist procedure with a small but real risk profile and imaging that can look worse before it looks better. The things worth planning are the follow-up schedule, the recovery window and what change on MRI is normal.

  • Thermal injury to adjacent structures

    The main risk. Real-time MR thermometry and safety thresholds around optic tract, brainstem and motor pathways keep the ablation on target - but not to zero.

  • Haemorrhage 2–5%

    Bleeding along the catheter track is the commonest surgical complication. Most are small and managed conservatively; a minority need further intervention.

  • Infection under 1%

    A single small burr hole and a short operating time keep infection rates very low compared with open craniotomy.

  • Catheter-related nerve deficit

    Rare, and usually related to trajectory rather than the ablation itself. Careful DTI-based planning is the mitigation.

  • Post-ablation oedema and headache

    Swelling around the ablation zone for 1–2 weeks is expected. Managed with a short steroid course and monitored on follow-up MRI.

  • Radiographic change vs true recurrence

    Post-LITT MRI can look worse before it looks better. SIC (subtraction ictal SPECT co-registered to MRI) and dedicated MRI protocols are used to tell treatment change from recurrence.

  • Seizure outcomes for MTS

    Engel I (seizure freedom) in roughly 55–65% at 12 months - slightly lower than open anterior temporal lobectomy, but with better preservation of verbal memory, particularly on the dominant side.

  • Local control for small metastases

    Local tumour control in the range of 70–90% at 6 months for selected small metastases, including lesions previously treated with SRS.

  • Red flags

    New weakness, worsening headache with vomiting, fever, spreading redness at the wound or a fresh seizure cluster all need same-day contact with the neurosurgical team or A&E.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever platform was used, the note the neurosurgical team sends you keeps to the same shape.

A UK consultant neurosurgeon reviewing a patient’s operation notes

A quiet reminder

Surgical 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 review, just ask.

  1. 01 Header

    Indication and target

    Why the ablation was done - MTS, hypothalamic hamartoma, deep glioma, metastasis, radiation necrosis - and the exact anatomical target.

  2. 02 Technique

    Stereotactic system and laser platform

    Whether ROSA, Neuromate, Renishaw or Leksell was used, which laser system (Visualase or NeuroBlate), the trajectory chosen and MR thermometry parameters.

  3. 03 Findings

    Ablation volume and dose delivered

    Volume ablated, damage estimate maps, whether the intended target volume was covered, and any margins spared for eloquent tissue.

  4. 04 Impression

    Recovery, imaging plan and outlook

    Read this first: expected recovery, when to return to work and driving, the imaging schedule at 6 weeks / 3 months / 6 months, and what change on follow-up is normal.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for LITT varies by insurer and by indication - usually funded when NHS commissioning criteria are met and MDT-approved, self-pay routes exist for cases that fall outside.

Frequently asked

Everything we get asked about neurosurgical laser ablation.

Quick answers on indications, UK centres, outcomes, risks and cost.

  • What is neurosurgical laser ablation (LITT)?

    MRI-guided laser interstitial thermal therapy - a minimally-invasive neurosurgical technique in which a laser catheter is passed through a roughly 3 mm burr hole to a deep brain target, and controlled thermal necrosis is delivered under real-time MR thermometry in the MRI scanner. See our general overview at /treatments/laser-interstitial-thermal-therapy.

  • Who is LITT for?

    Adults and selected children with drug-resistant mesial temporal lobe epilepsy, hypothalamic hamartoma, deep or brainstem gliomas, small brain metastases, symptomatic radiation necrosis, and selected deep cavernomas. A specialist MDT decides suitability.

  • Where is LITT available in the UK?

    A handful of specialist neurosurgical centres including King’s College Hospital, UCLH’s National Hospital for Neurology and Neurosurgery, and Great Ormond Street for paediatric cases. NHS commissioning is limited and MDT-gated.

  • How is LITT different from an open craniotomy?

    A single 3 mm burr hole replaces a large craniotomy. Anaesthetic time is shorter, HDU stay is typically 24 hours, and most patients go home within 2–3 days. The trade-off is that LITT is only suitable for defined targets, not large or diffuse disease.

  • How is LITT different from stereotactic radiosurgery (SRS)?

    SRS uses focused radiation and no incision. LITT uses a physical catheter and heat. LITT is often chosen when SRS has failed, for radiation necrosis, and for indications like MTS epilepsy where a mechanical ablation is preferred.

  • What are the seizure outcomes for temporal lobe epilepsy?

    Engel I (seizure freedom) in roughly 55–65% at 12 months for MTS-LITT. That is slightly lower than open anterior temporal lobectomy, but LITT preserves verbal memory better - often decisive for dominant-hemisphere cases.

  • How long is the recovery?

    HDU for 24 hours, ward for another 24–48 hours, then home. Most people are back to normal activity in 2–3 weeks. Driving depends on the indication - epilepsy patients follow DVLA seizure-free rules.

  • How much does private LITT cost in the UK?

    Roughly £28,000–£48,000 for MRI-guided LITT itself, plus pre-op work-up (video-EEG or MRS/DTI) and follow-up imaging. Combined biopsy plus LITT is £32,000–£55,000.

  • What are the main risks?

    Haemorrhage 2–5%, infection under 1%, thermal injury to adjacent structures, catheter-related nerve deficit (rare), and post-ablation swelling for 1–2 weeks. All are discussed by the neurosurgical team as part of consent.

  • When should I get urgent help after LITT?

    New weakness, worsening headache with vomiting, fever, spreading redness at the wound, or a fresh seizure cluster all need same-day contact with the neurosurgical team or A&E.

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