Gamma Knife, Brain Surgery Without Incision

Last Wednesday, me with other bloggers had a tour inside the Philippine Gamma Knife Center at the Cardinal Santos Medical Center in San Juan City.  This one-of-a-kind medical center is established in 1998 and since then, the Philippine Gamma Knife Center has performed more than 1,700 radiosurgical and open stereotactic procedures.

The Gamma Knife (also called as Leksell Gamma Knife) is a product of Elekta AB, a company in Sweden, used to treat brain tumors by administering high intensity radiation therapy in a manner that concentrates the radiation over a small volume. This scientific device was invented at the Karolinska Institute in Stockholm, Sweden back in 1967 by Lars Leksell, a neurosurgeon, and Börje Larsson, a radiobiologist from Uppsala University in the same country.

In a nutshell, The Gamma Knife isn't really a knife at all, but radiosurgery - a non-invasive neurosurgical procedure that uses powerful doses of radiation to target and treat diseased brain tissue while leaving all those surrounding tissue intact. The main difference of Gamma Knife is it can perform successful brain surgery without a knife.

This Youtube video below will describe Gamma Knife surgery, and what a patient will experience before, during and after the treatment:

Since Gamma Knife means surgery without incision, after your operation you can go back to your pre-operative lifestyle! That's so different if you chose the usual open surgery, which will take 10 to 16 days before you can recover back to being normal.

Below are the photos I took during the tour with bloggers:

One of their doctors, Dr. Monserrat Velasquez, welcomed us and told us things to expect during the tour.

RN Mario Louis Bumatay is showing us the "frame" that they will put on the patient's head. This is the first step, frame fixation. Basically they will put these lightweight frame on the patient's head. Your hair doesn't need to be cut nor shaved. Local anesthesia  is applied where the frame is to be attached. These frame will be fixed in the head with four special small screws, they need this in order to keep you head in a stable position during the imaging and treatment.

RN Bumatay candidly put the frame in his head =)

The next part is the imaging, a coordinate box will be used throughout the imaging process just to provide reference points on the images for the patient's treatment plan. This must be done with the special frame on,  to precisely define the location, size and the shape of the area with tumor.

Dr. Theodore Vesagas is looking at the LCD monitor which produce rich three dimensional images of the patient's brain. 

The third part is, treatment planning, after all the images have been recorded, a doctor will develop a treatment plan. Other specialists in the team will produce a 3D treatment plan, this is tailor-fit for the patient and for their specific medical condition. It must be re-checked many times and be approved for security reasons.

The round silver thingy below is called a collimators, which has varied sizes. The Gamma Knife system is equipped with a series of 4 collimators of 4mm, 8mm, 12mm and 16mm diameter, and is capable of submillimeter accuracies. 

The last part is,Treatment, this is when the doctor will tell their patient how long the treatment will last. This treatment is silent and  painless. The patient will lay down on the treatment table, head frame will be attached to the collimator in the Gamma Knife system. During these part, patient is wide awake and can communicate with the doctors and nurses through a camera with audio connection.

The respect given to Gamma Knife Radiosurgery is based on three significant reasons: its guaranteed quick recovery time, its high performance rating among experts and patients alike, and the team of experts who perform these procedure.


Gamma Knife minimizes the possibility of developing complications. Following the patient’s admission, a stereotactic frame is attached to the patient’s head, then, neuroimaging such as MRI, CT Scan or cerebral angiography is performed. A marker on the stereotactic frame allows the Gamma Knife team to localize the tumor or vascular malformation with exact precision on a state of the art computer work station. When the plan is complete, actual treatment will follow which usually last a single day.

“Compared to conventional open surgery, Gamma Knife allows the patients to return to his daily activities quickly and cost effectively. Because the Gamma Knife requires no incisions, and in most cases requires local anesthesia, many of the risk associated with conventional surgery such as infection, hemorrhage, adverse reaction to anesthesia and death are actually eliminated. It is usually performed as an out patient basis with no associated convalescence. Most patients resume their normal activities after discharge from the center.


But more than quick recovery time, what is being commended by doctors and Gamma Knife patients alike is the accuracy with which Gamma Knife treats a brain disorder. In fact, there is no other procedure that can claim to have greater acceptance among the world’s leading hospitals and medical practitioners when it comes to the non-invasive treatment of brain disorders than Gamma Knife.

Here, no scalpels are required and no blood is shed. Patients undergoing the Gamma Knife procedure will have their brain disorders treated, instead, through the delivery of a high single dose of radiation to that area that is affected. That makes it safer as surrounding tissues will not be affected during or after the procedure.

Patients whose lives have been changed after a Gamma Knife treatment also number in hundreds of thousands around the world. The technology involved in this procedure ensures its precision in treating a brain disorder. It has been proven to be one of the most successful radiosurgery weapons in the fight against brain disorders such as arteriovenous malformation, benign intracranial tumors including acoustic neuromas, meningiomas, pituitary adenomas, craniopharyngiomas, pineal tumors, malignant tumors such as metastatic carcinoma and nasopharyngeal carcinoma.


Since its clinical start-up in 1998, the Philippine Gamma Knife Center has performed over 1700 radiosurgical and open stereotactic procedures. The safety and effectiveness of the Gamma Knife procedure is ensured by a multi disciplinary team of medical professionals which are all trained in Stockholm, Sweden.

The team is composed of Neurosurgeons, headed by Dr. Vesagas who currently sits on the Board of Directors of the Asian Leksell Gamma Knife Society, Radiation Oncologist, Medical Physicist, Anesthesiologist and Neurosurgical Nurse with years of experience behind them. Averaging 130 cases a year, the Stereotactic Neurosurgery team at the Philippine Gamma Knife Center is the most experienced in the country, bar none.

GAMMA KNIFE Procedure here in the Philippines, can cost up to P550,000, that's all in (MRI's, room fees, miscellaneous fees, blood tests and other medical services, etc.) yes is sounds so expensive but when you compare the expenses on a normal open-skull surgery and it's post-operation costs, this is reasonable enough. Remember this is almost painless and the procedure won't last all day.

Need to know more information about how Philippine Gamma Knife Center can help you? Just visit the center at the Cardinal Santos Medical Center or visit their official website at or drop them a call at  725-9254 or 723-7575.



  1. that silver thing looks cool! I wished I could be invited in tours like this!

  2. thanks for the comment, actually i'm afraid of hospitals but seeing those things made me forget about it :D


  4. actually PGKC is not part of Cardinal Santos Medical Center, they're separate from each other. The center is just situated in the same area :D

  5. I think the silver thing is the one you use in straining water. just kidding... It is nice to know we have this high tech medical machines in the our country.

  6. very interesting! may price ba yung treatment?so yung mga nag treatment di na kailangan i confine? interesting!

  7. The "gadget" looks intimidating though.

  8. That's quite an innovation! This is a very concise post!

  9. @LEIRA: the whole procedure is priced P550,000 no confinement needed :D

    @Renz: so true! :D it looks like it came from outer space.

    @Sire Arevalo: yes, it's one-of-a-kind hospital! Thank you guys for the comment :D

  10. interesting and great pictures!,.

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