Endoscopic brain surgery is a procedure used primarily to treat brain tumors. It is considered a minimally invasive brain surgery that allows neurosurgeons to identify and treat conditions that are deep within the brain. This type of surgery allows us to treat brain tumors less invasively than traditional open brain surgery, while still affording us the ability to get an in depth view of the brain.
The optical advantages of an endoscopic (such as a wide angled panoramic view, an angled view by angled lens endoscopes, and a view in the tumor removal cavity) enhance tumor removal even in complex cases of bulky tumors. Most patients are able to go home in 2-3 days.
What is endoscopic neurosurgery?
Endoscopic neurosurgery may be completely endoscopic or may be endoscopic assisted neurosurgery purely users key hole approach with use of endoscopic and its instruments to remove the diseased part. In Endoscopic assisted neurosurgery endoscope is used to assist the micro neurosurgery, meaning that major part of the surgery is done with the help of microscopewith some assistance of endoscopic during the surgery. Most often endoscopic assisted neurosurgery will be a part of minimally invasive neurosurgery (small cosmetic incision).
Therefore both endoscopic neurosurgery and minimally invasive neurosurgery serve the same purpose of achieving the goal through small cosmetically concealed skin incisions.
Endoscopic Assisted Neurosurgery:
This is an operation conducted using a sophisticated neurological operating microscope for visualization and advanced micro neurosurgical techniques, to surgically manage a disease process. During the operation an endoscopic is introduced into the operative an endoscopic is introduced into the operative area to permit visualization of structures beyond the range of the operating microscope such as around corners or “underneath” other deep anatomical structures. The Endoscopic image can be viewed on a television monitor, or through a “heads up” display projected to the operating microscope.
Procedures done with endoscopic assisted micro neurosurgery are aneurysms, most of skull base tumors, epidermoid cysts of the brain, Trigeminal Neuralgia, acoustic schwannomas, and others.
Procedures done on brain with pure endoscopic approach are:-
* Third Ventriculostomy (for Hydrocephalus)
* Intraventricular operations for removal of tumors
* Third ventricular colloid cyst and
* Fenestration Resection of intracranial arachnoid cysts
* Endoscopic pituitary surgery
* Endoscopic skull base tumor excisions
Endoscopic Pituitary Surgery:
Endoscopic pituitary surgery, also called as Transnasal Transphenoidal Endoscopic Pituitary Adenoma Surgery is Performed through a natural nasal air pathway through the nose without any incisions unlike the conventional microscopic surgery performed with an incision made under the upper lip or inner aspect of a nostril. Endoscopic surgery does not require the use of a metallic transsphenoidal retractor that is used for conventional microscopic Transnasal Transphenoidal Pituitary Tumor Surgery. A 4-mm endoscope is placed in front of the tumor in the sphenoidal sinus and the tumor is removed with specially designed surgical tools. Postoperative nasal packing is not necessary, and postoperative discomfort in minimal. Most patients are able to go home the following day. The optical advantages of an endoscope (such as a wide –angled panoramic view, an angled view by angled lens endoscope, and a view in the tumor removal cavity) enhance tumor removal even in complex cases of bulky tumors.
Endoscopic Treatment of Hydrocephalus: Hydrocephalus is a condition in which the normal circulatory pathways of cerebrospinal fluid (CSF) are altered. Hydrocephalus can result from a number of conditions including congenital malformations, infection, hemorrhage, or brain tumors. With the accumulation of CSF, the intracranial pressure increase resulting in symptoms such as headache, vomiting, altered personality and decreased cognitive performance. Hydrocephalus was perniciously treated by VP and VA shunts which had a significant rate of failure requiring frequent hospitalizations and additional surgery.