A lesionectomy is a type of epilepsy surgery that removes abnormal brain tissue where seizures begin. It is also known as a focal resection. Duke Health neurosurgeons carefully evaluate whether surrounding tissue is contributing to seizure activity and recommend a surgical approach that will deliver the best outcome.
The most common types of lesions (abnormal areas of brain tissue) removed during a lesionectomy include:
Children and adults undergo a thorough surgical evaluation before a treatment is recommended. Learn more about:
Duke neurosurgeons may recommend a traditional open approach or minimally invasive laser approach for lesionectomy surgery.
Lesionectomy – Open Approach
A neurosurgeon performs a craniotomy to create an opening in the skull to reach and remove the brain lesion. After surgery, you’ll stay in the hospital for several days. Most people return to normal activities in about six weeks.
Minimally Invasive Approach with Laser Ablation
A neurosurgeon drills one or two small holes, about the diameter of a pencil, into the skull. Using MRI guidance, a laser probe is passed through the holes to target and eliminate the lesion.
This type of laser interstitial thermal therapy (LITT) may reduce your post-surgical hospital stay and speed recovery.
As a Level 4 Epilepsy Center, Duke Health provides the highest level of diagnosis, medical, and surgical treatments for people with epilepsy. It is one reason why Duke University Hospital’s neurology and neurosurgery program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report in 2025-2026.