Difference Between Radiofrequency Ablation and Laser Ablation

Radiofrequency and laser ablation are two minimally invasive treatment options that use thermal energy to destroy tissues. But how do these procedures work and what distinguishes them from one another? Read on for a detailed comparison of these two modalities.

What is Radiofrequency Ablation?

Radiofrequency ablation (RFA) utilizes radiofrequency waves to generate heat and destroy abnormal tissues. A thin needle probe is inserted directly into the targeted area, whether it be a tumor, nerve, or source of arrhythmia in the heart. The probe emits energy that heats the surrounding tissues to temperatures between 70-90°C, causing cellular death and damage.

The high-frequency alternating current creates a small region of heat around the needle, sparing the surrounding healthy tissues. This allows for very precise ablation of undesirable growths or malfunctioning tissues.

What is Laser Ablation?

Laser ablation also works by thermal energy, but instead of radiofrequency waves, it uses highly focused beams of light. A thin optical fiber delivers laser energy directly to the abnormal tissue that needs to be removed.

When the beam hits the targeted cells, it is absorbed and converted into heat energy that destroys the tissues. Lasers can be carefully controlled to penetrate just a few cm into the body, enabling extremely accurate and minimally invasive treatment.

Fundamental Principles Behind Each Technique

The primary difference lies in the type of energy delivered:

  • Radiofrequency ablation utilizes thermal energy from radiofrequency waves penetrating tissue from the needle probe.
  • Laser ablation harnesses photonic energy from highly concentrated light beams emitted from the laser fiber.

Both methods induce targeted cellular death through tissue heating but use different physics concepts to generate this thermal damage.

Areas of the Body Treated

  • Radiofrequency ablation is commonly used to ablate cardiac arrhythmia substrates, liver, kidneys, lungs, bone tumors, and sensory and motor nerves causing chronic pain.
  • Laser ablation tends to be applied in more delicate areas like the brain, spine, eyes, thyroid, and prostate. The precision of the laser allows it to treat tumors and tissues in areas where collateral damage needs to be minimized.


Devices Used in Each Procedure

  • Radiofrequency ablation requires a generator device that delivers alternating current and a needle-like probe to the site.
  • Laser ablation uses a laser machine coupled to thin optical fibers to guide the laser light. For some procedures, a flexible laser endoscope may be utilized.

Step-by-Step Procedure Methodology

Radiofrequency Ablation

  1. The patient receives local anesthetic at the insertion site. Conscious sedation or general anesthesia may also be administered.
  2. The physician inserts one or more thin probes into the targeted tissue using imaging guidance like ultrasound, CT, or MRI.
  3. The RF generator connected to the probes delivers alternating current, which agitates molecules in the tissue, producing friction and heat.
  4. The tissues around the needle are heated to 60-100°C for 4-6 minutes, destroying cells via coagulation necrosis.
  5. The probes are removed, and pressure is applied to prevent bleeding.

Laser Ablation

  1. The patient is given a local or general anesthetic before the procedure.
  2. The physician inserts the narrow optical fiber through a small nick in the skin or a natural opening.
  3. Infrared laser light travels through the fiber to the abnormal tissue.
  4. The laser beam precisely destroys the targeted cells via photothermal ablation.
  5. Multiple areas can be treated by repositioning the fiber.
  6. The fiber is withdrawn, and the entry site is closed.

Treatment Duration

  • Radiofrequency ablation procedures typically take one to two hours depending on the size of the lesion being treated.
  • Laser ablation procedures run longer, usually lasting about 30 minutes to 2 hours on average when treating larger tumors or multiple sites.

Anesthesia Required

  • Radiofrequency ablation is generally performed as an outpatient procedure under local anesthesia, sometimes with added conscious sedation.
  • Laser ablation often requires general anesthesia, particularly procedures within the brain or spine that demand greater immobilization.

Side Effects and Risks

Both modalities carry some common risks like infection, bleeding, or damage to nearby healthy tissues. Other potential side effects include:

  • Radiofrequency ablation: Pain, swelling, nerve injury in surrounding areas. Adverse reactions to anesthetic agents.
  • Laser ablation: Heat damage to blood vessels or important structures. Eye injury if used near ocular areas. Respiratory and cardiovascular side effects if general anesthesia is utilized.

Recovery and Post-Procedure Care

  • Patients can usually go home the same day after radiofrequency ablations, resuming normal activities within 1-2 days. Mild discomfort at the puncture site may persist for 1-2 weeks.
  • Laser ablation requires 1-2 weeks to heal before normal activity can be resumed. Lengthier procedures under general anesthesia have more downtime.

Effectiveness and Success Rates

  • Reported success rates for radiofrequency ablation are around 70-80%, depending on the specific indication. It may require multiple sessions.
  • The effectiveness of laser ablation varies. In one study examining its use for OCD, success rates were 60-70%. Other applications may have higher or lower success rates.

Cost Comparison

  • As per NIH, the average cost of radiofrequency ablation is $5,411 per procedure without insurance.
  • Laser ablation costs around $1000-2500 per session, depending on the targeted area and complexity.


When is Radiofrequency or Laser Ablation Most Appropriate?

Whether radiofrequency or laser ablation is most suitable depends on the patient’s condition, the size and location of the tissue to be removed, and the physician’s expertise.

Doctors consider ablation when conditions like atrial fibrillation, thyroid nodules, or nerve pain fail more conservative treatments. Studies directly comparing RFA and LA for certain indications can also help guide appropriate patient selection.

Ultimately, patients should consult their doctor to determine whether ablation is warranted and which modality is preferable based on their circumstances.


Radiofrequency and laser ablation offer less invasive ways to eliminate problematic tissues in many body parts. Both techniques have high precision capabilities, relatively low complication rates, and success levels for the right indications.

Advancements continue to expand the possibilities for precise and effective ablation therapies with quicker recovery times. By understanding the fundamental differences between available modalities, patients can make well-informed choices about the best treatment options for their health conditions.


Optimal Temperature for Radiofrequency Ablation of Lumbar Medial Branches for Treatment of Facet-Mediated Back Pain

Radiofrequency ablation: Procedure, recovery, and outcome

Laser ablation: Expert minimally invasive treatment for epilepsy and brain tumors – Mayo Clinic

Radiofrequency Ablation | Conditions & Treatments | UCSF Health

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