Over 70 years ago, Professor Lars Leksell discovered that by minimising surgical intervention in the skull, the mortality rate could be reduced along with the trauma to the patient. This concept led to the birth of minimally and non-invasive neurosurgery and stereotactic radiosurgery which involves delivering a single, high dose of radiation to a small and critically located target in the brain.
Lars Leksell was a Swedish physician and Professor of Neurosurgery at the Karolinska Institute in Stockholm, Sweden. He was the inventor of radiosurgery.
Leksell Gamma Knife
The stereotactic concept of directing beams of X-rays into the brain was used surgically for the first time in 1951 and the first Leksell Gamma Knife prototype for clinical research was introduced in 1968. In the 1980’s, the first commercial deliveries of Leksell Gamma Knife systems were made. The unsurpassed clinical effectiveness of the treatments conducted saw a dramatic increase in the number of publications and it soon became the worldwide gold standard for stereotactic brain surgery.
The number of patients to undergo Gamma Knife surgery has risen from about 7,000 patients in 1991 to over one million today with some 80,000 patients treated annually. Statistics on indications treated can be found here.Correspondingly, the number of units installed globally now exceeds nearly 300 centres. Thousands of peer reviewed articles have been published providing strong evidence on the clinical effectiveness of Gamma Knife surgery for a number of indications. It is also evident that it is a cost effective treatment as compared to other treatment modalities offering opportunities to the NHS, currently facing an unprecedented financial challenge, to contribute to efficiency gains and improved patient experience and outcomes.
With very few exceptions, Gamma Knife surgery is given on a single occasion and without general anesthesia. After Gamma Knife surgery the patient normally leaves the hospital on the same day or the day after. During the procedure, some 200 radiation beams from cobalt-60 sources converge with high accuracy on the target. Each individual beam has low intensity and therefore does not affect the tissue through which it passes on its way to the target. The beams converge in an isocentre where the cumulative radiation intensity becomes extremely high.
By moving the patient’s head in relation to the beam’ isocentre the radiation dose can be optimised in relation to the shape and size of the target. The extreme precision of Leksell Gamma Knife, better than 0.5mm, makes it possible to administer a high radiation dose to the lesion with minimal risk of damaging healthy tissue.
The centre has purchased a Leksell Gamma Knife® Perfexion™. Perfexion which dramatically streamlines workflow and expands the treatable volume through an automated, multi-source collimator. It offers protocol reproducibility with full backward compatibility allowing the treatment experience of over 500,000 patients to be built upon. With robotic efficiency it can treat a wider range of targets faster and more efficiently than ever before. The dedicated treatment planning system (Leksell GammaPlan) facilitates creation of even the most complex plans by configuring composite shots enabling sculpting the dose distribution, which is then delivered with the unmatched accuracy associated with Gamma Knife surgery. Every feature of the system reflects patient safety and comfort e.g. it provides radiation shielding which is up to 100 times better than alternative technologies. Please view the video above for an introduction to the technology.
Despite the new NHSE commissioning policies the number of patients being treated by Gamma Knife surgery remains lower in the UK than needs estimates suggest and to rates seen in many other similar countries. This needs to change and requires continued and sustained efforts to increase awareness, training and provision and we are committed to working in partnership to achieve this. If you require any further information please do not hesitate to contact us. We would be delighted to host a visit for you to the centre and would welcome an opportunity to discuss how we may work in partnership. You may also consider attending some events details of which can be found here.