“Minimally invasive” means that the surgical procedure is performed with as little strain on the body as possible. Instead of making large incisions and extensive openings in the skull or spine, neurosurgeons are increasingly using smaller access points, specialized instruments, and state-of-the-art technology. This ensures that only the tissue that is truly necessary for the treatment is affected—healthy tissue remains largely intact.
How does minimally invasive and endoscopic neurosurgery work?
Even in minimally invasive and endoscopic neurosurgery, the optimal treatment of the condition and patient safety remain the top priorities. Neurosurgeons work through small “keyhole” incisions using special, delicate instruments, allowing them to treat diseased tissue in the brain or along the nerves with precision and as gently as possible. Modern techniques ensure precise visualization and control, thereby providing the highest possible level of safety during the procedure.
- Smaller incisions, greater precision: Instead of long skin incisions and large openings in the skull, often just a few centimeters are enough to access the interior of the skull using fine instruments and endoscopes (small cameras).
- Modern technology as an aid: With neuronavigation (a kind of 3D GPS for the operating room) and intraoperative MRI or ultrasound, surgeons can see exactly where they are during surgery—and immediately check whether the desired result has been achieved.
- Customized Planning: Each surgery is carefully planned in advance based on MRI or CT images. This ensures that the approach is optimally tailored to the patient’s anatomy and condition. Technical tools such as “augmented reality” are also often used in the planning process.
What are the advantages of minimally invasive and endoscopic neurosurgery?
For patients, less tissue damage usually means less pain, fewer scars, and a faster recovery. Patients who undergo minimally invasive neurosurgical procedures benefit primarily from the following advantages:
- smaller scars,
- less pain after surgery,
- lower risk of infection,
- Back home and to your daily routine faster.
What conditions can be treated with minimally invasive neurosurgery?
Preserving healthy tissue is particularly important when treating conditions located deep within the skull. This is the case, for example, with tumors at the base of the skull and cysts within the ventricles of the brain. Various minimally invasive surgical techniques can be used to treat these conditions:
Transnasal Endoscopic Surgery
The surgery is performed through the nose, leaving no visible external scar. In this procedure, the skull opening is created “below” the brain, which means the surgeon does not have to operate through healthy brain tissue. This procedure is used, for example, to treat pituitary adenomas and cysts, craniopharyngiomas, and bone tumors in the region of the central skull base.
Endoscopically-assisted microsurgery via “keyhole” approaches
The surgery is performed through a small incision in the skin (e.g., within the eyebrow) and a craniotomy—a precise opening in the skull—usually guided by neuronavigation. The surgery is primarily performed under a microscope. However, with the help of an endoscope and angled instruments, it is possible to visualize and manipulate even otherwise hidden areas deep within the surgical field. These approaches are used, for example, for surgeries at the base of the skull (meningiomas, schwannomas, epidermoid/dermoid cysts).
Ventriculoscopic Surgery
Certain procedures involving the brain’s ventricles can be performed using a special endoscope equipped with working channels for fine surgical instruments (ventriculoscope). To do this, all that’s needed is to drill a small hole in the skull. Under direct visualization, it is possible, for example, to create additional drainage pathways for cerebrospinal fluid in cases of cerebrospinal fluid accumulation (hydrocephalus). In addition, this procedure can be used to remove cysts in the ventricles (e.g., colloid cysts or arachnoid cysts) or to obtain tissue samples from tumors.
Procedure for a Minimally Invasive and Endoscopic Surgery
Minimally invasive surgeries require careful and individualized planning for each patient. The primary focus is on optimally achieving the surgical goal while minimizing tissue damage and cosmetic impairment. This planning is based on the imaging (MRI/CT) performed prior to surgery and the patient’s individual anatomy. During our consultation, we will discuss in detail the procedures and risks associated with the planned surgery, as well as possible alternative surgical techniques.
The surgery is carefully planned by the surgeon for each individual patient and is then usually performed by the surgeon personally to ensure that the patient’s specific needs are optimally addressed. After the procedure, the treating surgeon generally continues to provide personal care to the patient in order to address the specific details of the individual procedure.
