Lars Leksell
Encyclopedia
Lars Leksell was a Swedish physician
and Professor of Neurosurgery
at the Karolinska Institute in Stockholm
, Sweden
. He was the inventor of radiosurgery
.
, Sweden
on November 23, 1907. He graduated in Medicine
at the Karolinska Institute in 1935 and began training in neurosurgery in the same year. He became a professor of surgery at University of Lund in 1958. From 1960 until his retirement, in 1974, he was Professor of Neurosurgery at the Karolinska Institute in Stockholm, succeeding Herbert Olivecrona, who was the department's founder in 1920. He died in 1986.
Professor Lars Leksell was one of the first to develop a stereotactic apparatus
exclusively for human functional neurosurgery
in 1949, following the pioneering work of American neurosurgeons Ernest A. Spiegel and Henry T. Wycis in 1947. It was based on the Horsley–Clarke apparatus developed for animal experimentation by the British neurosurgeon Sir Victor Horsley
at University College London
in 1908, but instead of using the cartesian
coordinate frame, it used polar coordinates. The Leksell Stereotactic Frame was and still is in wide use today. Using it, Leksell and his collaborators stand also among the pioneers in the surgical approach to the treatment of Parkinson's Disease
, a degenerative condition of the motor system of the brain, by precisely lesioning a small structure in the basal ganglia
, by means of an operation called pallidotomy
.
In 1951, using the Uppsala University
cyclotron
, Leksell and the physicist and radiobiologist Borje Larsson, developed the concept of radiosurgery
. Leksell and Larsson first employed proton beams coming from several directions into a small area into the brain
, in experiments in animals and in the first treatments of human patients. He called this technique "strålkniven" (the ray knife). Thus, he achieved a new non-invasive method of destroying discrete anatomical regions within the brain while minimizing the effect on the surrounding tissues. Later, a special apparatus known as the Gamma Knife, was developed by Lars Leksell in 1968. It is a sterotactice device which contains multiple radioactive cobalt
sources and is dedicated solely to radiosurgery. Today, Leksell's technique is used as an effective treatment for many conditions such as vestibular schwannomas (first surgery performed at Karolinska in 1969), pituitary tumors (also in 1969), arteriovenous malformation
s (in 1970) craniopharyngioma
s, meningioma
s (in 1976), metastatic and skull
base tumors (in 1986), and primary brain tumors. The Leksell Gamma Knife is manufactured by Elekta Instruments AB
, a Swedish company which manufactures stereotactical surgery and radiosurgery equipment, based on the inventions of Lars Leksell. It was founded by him and his son, Laurent Leksell, in 1972.
Lars Leksell served as a mentor for a number of other leading neurosurgeons including L. Dade Lunsford who established the first U.S. Gamma Knife center at the University of Pittsburgh
and Stanford Professor John R. Adler
, the inventor of Cyberknife
.
Leksell has worked also in neurophysiology
. His most noted contribution was the description of the gamma motor system of the nervous system
.
Aside from the Gamms Knife, Leskell created a few surgical instruments to assist in neurosurgical procedures, most notably the Leskell Rongeur
. The Leksell Rongeur is used to bite pieces of bone off of the skull or spinal lamina to expose the structures below.
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
and Professor of Neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
at the Karolinska Institute in Stockholm
Stockholm
Stockholm is the capital and the largest city of Sweden and constitutes the most populated urban area in Scandinavia. Stockholm is the most populous city in Sweden, with a population of 851,155 in the municipality , 1.37 million in the urban area , and around 2.1 million in the metropolitan area...
, Sweden
Sweden
Sweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe. Sweden borders with Norway and Finland and is connected to Denmark by a bridge-tunnel across the Öresund....
. He was the inventor of radiosurgery
Radiosurgery
Radiosurgery is a medical procedure that allows non-invasive treatment of benign and malignant tumors. It is also known as stereotactic radiotherapy, when used to target lesions in the brain, and stereotactic body radiotherapy when used to target lesions in the body...
.
Life and work
Lars Leksell was born in Fässberg ParishFässberg Parish
Fässberg Parish is a parish in the Diocese of Gothenburg in Sweden. It covers most of the town of Mölndal....
, Sweden
Sweden
Sweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe. Sweden borders with Norway and Finland and is connected to Denmark by a bridge-tunnel across the Öresund....
on November 23, 1907. He graduated in Medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
at the Karolinska Institute in 1935 and began training in neurosurgery in the same year. He became a professor of surgery at University of Lund in 1958. From 1960 until his retirement, in 1974, he was Professor of Neurosurgery at the Karolinska Institute in Stockholm, succeeding Herbert Olivecrona, who was the department's founder in 1920. He died in 1986.
Professor Lars Leksell was one of the first to develop a stereotactic apparatus
Stereotactic surgery
Stereotactic surgery or stereotaxy is a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinates system to locate small targets inside the body and to perform on them some action such as ablation, biopsy, lesion, injection, stimulation, implantation,...
exclusively for human functional neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
in 1949, following the pioneering work of American neurosurgeons Ernest A. Spiegel and Henry T. Wycis in 1947. It was based on the Horsley–Clarke apparatus developed for animal experimentation by the British neurosurgeon Sir Victor Horsley
Victor Horsley
Sir Victor Alexander Haden Horsley was an accomplished scientist and professor. He was born in Kensington, London. He was educated at Cranbrook School, Kent and studied medicine at University College London and in Berlin, Germany , and in the same year started his career as a house surgeon and...
at University College London
University College London
University College London is a public research university located in London, United Kingdom and the oldest and largest constituent college of the federal University of London...
in 1908, but instead of using the cartesian
Cartesian coordinate system
A Cartesian coordinate system specifies each point uniquely in a plane by a pair of numerical coordinates, which are the signed distances from the point to two fixed perpendicular directed lines, measured in the same unit of length...
coordinate frame, it used polar coordinates. The Leksell Stereotactic Frame was and still is in wide use today. Using it, Leksell and his collaborators stand also among the pioneers in the surgical approach to the treatment of Parkinson's Disease
Parkinson's disease
Parkinson's disease is a degenerative disorder of the central nervous system...
, a degenerative condition of the motor system of the brain, by precisely lesioning a small structure in the basal ganglia
Basal ganglia
The basal ganglia are a group of nuclei of varied origin in the brains of vertebrates that act as a cohesive functional unit. They are situated at the base of the forebrain and are strongly connected with the cerebral cortex, thalamus and other brain areas...
, by means of an operation called pallidotomy
Pallidotomy
Pallidotomy is a procedure where a tiny electrical probe is placed in the globus pallidus , which is then heated to 80 degrees celsius for 60 seconds, to destroy a small area of brain cells...
.
In 1951, using the Uppsala University
Uppsala University
Uppsala University is a research university in Uppsala, Sweden, and is the oldest university in Scandinavia, founded in 1477. It consistently ranks among the best universities in Northern Europe in international rankings and is generally considered one of the most prestigious institutions of...
cyclotron
Cyclotron
In technology, a cyclotron is a type of particle accelerator. In physics, the cyclotron frequency or gyrofrequency is the frequency of a charged particle moving perpendicularly to the direction of a uniform magnetic field, i.e. a magnetic field of constant magnitude and direction...
, Leksell and the physicist and radiobiologist Borje Larsson, developed the concept of radiosurgery
Radiosurgery
Radiosurgery is a medical procedure that allows non-invasive treatment of benign and malignant tumors. It is also known as stereotactic radiotherapy, when used to target lesions in the brain, and stereotactic body radiotherapy when used to target lesions in the body...
. Leksell and Larsson first employed proton beams coming from several directions into a small area into the brain
Brain
The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...
, in experiments in animals and in the first treatments of human patients. He called this technique "strålkniven" (the ray knife). Thus, he achieved a new non-invasive method of destroying discrete anatomical regions within the brain while minimizing the effect on the surrounding tissues. Later, a special apparatus known as the Gamma Knife, was developed by Lars Leksell in 1968. It is a sterotactice device which contains multiple radioactive cobalt
Cobalt
Cobalt is a chemical element with symbol Co and atomic number 27. It is found naturally only in chemically combined form. The free element, produced by reductive smelting, is a hard, lustrous, silver-gray metal....
sources and is dedicated solely to radiosurgery. Today, Leksell's technique is used as an effective treatment for many conditions such as vestibular schwannomas (first surgery performed at Karolinska in 1969), pituitary tumors (also in 1969), arteriovenous malformation
Arteriovenous malformation
Arteriovenous malformation or AVM is an abnormal connection between veins and arteries, usually congenital. This pathology is widely known because of its occurrence in the central nervous system, but can appear in any location. An arteriovenous malformation is a vascular anomaly. It is a...
s (in 1970) craniopharyngioma
Craniopharyngioma
Craniopharyngioma is a type of brain tumor derived from pituitary gland embryonic tissue, that occurs most commonly in children but also in men and women in their 50s and 60s....
s, meningioma
Meningioma
The word meningioma was first used by Harvey Cushing in 1922 to describe a tumor originating from the meninges, the membranous layers surrounding the CNS ....
s (in 1976), metastatic and skull
Human skull
The human skull is a bony structure, skeleton, that is in the human head and which supports the structures of the face and forms a cavity for the brain.In humans, the adult skull is normally made up of 22 bones...
base tumors (in 1986), and primary brain tumors. The Leksell Gamma Knife is manufactured by Elekta Instruments AB
Elekta
Elekta is a swedish company that provides radiation therapy, radiosurgery, related equipment and clinical management for the treatment of cancer and brain disorders.-History:...
, a Swedish company which manufactures stereotactical surgery and radiosurgery equipment, based on the inventions of Lars Leksell. It was founded by him and his son, Laurent Leksell, in 1972.
Lars Leksell served as a mentor for a number of other leading neurosurgeons including L. Dade Lunsford who established the first U.S. Gamma Knife center at the University of Pittsburgh
University of Pittsburgh
The University of Pittsburgh, commonly referred to as Pitt, is a state-related research university located in Pittsburgh, Pennsylvania, United States. Founded as Pittsburgh Academy in 1787 on what was then the American frontier, Pitt is one of the oldest continuously chartered institutions of...
and Stanford Professor John R. Adler
John R. Adler
John R. Adler M.D. is a neurosurgeon, the Dorothy and Thye King Chan Endowed Professor of Neurosurgery at Stanford University School of Medicine and Vice Chair for Innovation and Technology in the Department of Neurosurgery at Stanford University School of Medicine.Clinically, Dr. Adler...
, the inventor of Cyberknife
Cyberknife
The CyberKnife is a frameless robotic radiosurgery system used for treating benign tumors, malignant tumors and other medical conditions. The system was invented by John R. Adler, a Stanford University Professor of Neurosurgery and Radiation Oncology, and Peter and Russell Schonberg of Schonberg...
.
Leksell has worked also in neurophysiology
Neurophysiology
Neurophysiology is a part of physiology. Neurophysiology is the study of nervous system function...
. His most noted contribution was the description of the gamma motor system of the nervous system
Nervous system
The nervous system is an organ system containing a network of specialized cells called neurons that coordinate the actions of an animal and transmit signals between different parts of its body. In most animals the nervous system consists of two parts, central and peripheral. The central nervous...
.
Aside from the Gamms Knife, Leskell created a few surgical instruments to assist in neurosurgical procedures, most notably the Leskell Rongeur
Rongeur
A rongeur is a strongly constructed instrument with a sharp-edged, scoop-shaped tip, used for gouging out bone. Rongeur is a French word that means rodent or 'gnawer'. A rongeur can be used to open a window in bone, often in the skull. It is used in neurosurgery and orthopedic surgery to expose...
. The Leksell Rongeur is used to bite pieces of bone off of the skull or spinal lamina to expose the structures below.
Quotation
Tools used by the surgeon must be adapted to the task and where the human brain is concerned, no tool can be too refined. Lars Leksell.To know more
- The History of Stereotactical Radiosurgery, by Stephen B. Tatter, MD, PhD, Massachusetts General Hospital, Dept. Neurosurgery.
- Elekta Instruments, Inc, Home Page
- Lunsford LD: Lars Leksell. Notes at the side of a raconteur. Stereotact Funct Neurosurg. 1996–97;67(3–4):153–68.