Surgery for Brain Mets

Surgery for Brain Mets
A team of surgeons performing brain surgery to remove a tumor.

Surgery is the first and most common treatment for people with brain tumors. For some tumors, surgical removal and continued monitoring may be the only treatment needed. The goals of the surgery could include:

  • Complete removal (resection) of the brain tumor
  • Partial removal of tumors near sensitive areas of the brain to relieve symptoms and facilitate or increase the effectiveness of other treatments. Less pressure within the skull can mean reduced symptoms and improved ability to function (for example, to think, speak, or see better).
  • A biopsy — a surgical procedure to remove a small sample of a brain tumor for examination under a microscope — is usually performed during surgery to remove the tumor. A biopsy can be performed as a separate procedure if the tumor can’t be removed without damaging critical parts of the brain or if the patient is otherwise not a candidate for surgery.

Types of Brain Surgery

The challenge of brain tumor surgery is removing as much of the tumor as possible without severely damaging normal brain tissue, which demands skill and experience, as well as advanced technology and a well-orchestrated team.

Today, doctors are using computerized technologies that are familiar to us in the consumer world to help them fight cancer in the operating room. An important example of that application is image guided surgery (IGS) and it helps surgeons perform safer and less invasive1 procedures and remove brain tumors that were once considered inoperable due to their size and/or location.


The most common type of surgery to remove a brain tumor is a craniotomy. This procedure involves making an incision in the scalp and removing a piece of bone from the skull to give the neurosurgeon access to the tumor. Carefully planned surgical procedures can help the neurosurgeon address challenging skull base tumors.

Surgically Targeted Radiation Therapy (STaRT)

GammaTile is a Surgically Targeted Radiation Therapy (STaRT) for operable brain tumors that provides immediate radiation treatment after tumor removal. Each GammaTile has radiation sources embedded in a collagen tile that deliver a precise dose of radiation focused right where it is needed and away from healthy brain tissue.

MRI-Guided Laser Ablation

MRI-guided laser ablation is a minimally invasive neurosurgical technique for a number of diseases, including brain tumors. The treatment uses lasers to target and destroy the tumor. The procedure can help surgeons address the most serious brain tumors, including glioblastoma multiforme and brain tumors that are located close to sensitive structures in the brain, making them hard to access through traditional open surgery. MRI-guided laser ablation can offer reduced pain after surgery and shorter recovery time compared with craniotomy.

Tubular Retractor System for Neurosurgery

The tubular retractor system is a new, minimally invasive procedure that can help your neurosurgeon manage several serious conditions, including brain tumors.

A retractor is any instrument that moves or holds tissue so a surgeon can reach a particular area. The tubular retractor is valuable because it moves aside the folds and delicate tissues of the brain with less risk of damage than other surgical methods — it displaces the tissue instead of cutting through it.

The tubular retractor system can be especially useful in situations when a tumor is located deep in the brain. It also offers a less invasive option than traditional open surgery (craniotomy).

Intraoperative Imaging

Specialized MRI and CT machines in the operating room provide real-time mapping of brain anatomy during surgery, helping doctors better navigate delicate structures surrounding the tumor. Neurosurgeons can also use intraoperative imaging to immediately check whether any lingering tumor tissue remains visible on scans.

Ommaya reservoirs are frequently used to deliver intraventricular chemotherapy in cancer patients with leptomeningeal metastases.  Leptomeningeal disease occurs when cancer cells migrate from your breast, lung, or some other part of your body to your cerebrospinal fluid (CSF). This liquid circulates nutrients and chemicals to the brain and spinal cord. Once cancer cells are in the CSF, they settle in a spot in the brain 

Ommaya reservoir, also known as Ommaya shunt, is a device for the purpose of repetitive access to the intrathecal space, consisting of an intraventricular catheter connected to a reservoir (port) implanted beneath the scalp. It is used for intrathecal administration of medication such as chemotherapy (mainly in the treatment of meningeal lymphomas, but also for other meningeal pathology) and palliative analgesics, as well as for CSF aspiration.