Keyhole neurosurgery. Minimally invasive neurosurgery for cerebral tumors

Why minimally invasive ?

  • Minimal tissue damage
  • We do not shave the hair
  • Small incisions (3-4 cm or even smaller), or without incisions for trans nasal surgery
  • Small craniotomy, strategically placed
  • We use anatomical corridors as much as possible 
  • We do not use brain retractors
  • We are restoring anatomy /  never making craniectomies  / always fixing bone flaps
  • Minimized risk of new neurological deficits 
    • Quick recovery / rapid mobilization
    • Shorter duration of hospitalization  (3 days on average)
  • Postoperative dressing is not required
  • Positive psychological impact on the family and patient
  • Operative site infections <1%

How we do it?

  • Preoperative planning – multidisciplinary team (neurosurgeons, anesthesiologist, oncologist, radiologist, radiotherapist, endocrinologist, pathologist etc .)
  • 3T MRI with neurologic highly specialized protocols (DTI, Perfusion MRI, AngioMR, high resolution structural images, functional images, etc.)

State-of the art technology

  • The operating microscope – high end robotic tehnology
  • Endoscopy – trans nasal, trans cranial and neuro endoscopy.
  • Neuronavigation connected to the microscope and endoscopes – with real time localisation of microscopic focus and endoscopic tips.
  • Electrophysiology is a monitoring instrument of the cerebral, spinal and peripheral neural pathways. Permanent monitoring of these pathways can be achieved through electrode implanting and stimulation. It helps to lower the neurological risks during the surgery, and is, in nowadays, indispensable for high quality and low risk neurosurgical interventions.
  • The ultrasonic aspirator is a surgical instrument which fragments and aspires the tumor, without putting any pulling tension on the brain. The tumor is fragmented by the tip of the instrument which vibrates at 36 000 Hz.
  • Neuroanesthesia techniques allow impressive surgeries like awake brain surgery. During the surgery, the patient is asked to perform specific tests that identify a functional cortical or subcortical area. The surgeon is reassured through direct stimulation of the cortex that he is not harming functional areas like speech, movement, sight.
NeuroHope clinic and a part of our technology

Examples of neurosurgical intervention in our clinic

Case 1

supra tentorial PNET – preoperative MRI
supra tentorial PNET – preoperative MRI
supra tentorial PNET – postoperative day 1 CT – gross total removal – gross total removal

Case 2

Choroid plexus papiloma – 7 day old girl – preoperative MRI
Choroid plexus papiloma – 7 day old girl – postoperative MRI – total removal

Case 3

Glioblastoma multicentric – GBM – preoperative MRI
Glioblastoma multicentric – GBM – preoperative MRI
Glioblastoma multicentric- two approaches – GBM – postoperative MRI – gross total removal
Glioblastoma multicentric – two approaches- GBM – postoperative MRI – gross total removal

Case 4

Pilocytic astrocytoma – subtotal resection in an other institution – preoperative MRI
Pilocytic astrocytoma – postoperative MRI

Case 5

Glioblastoma – GBM – preoperative MRI
Glioblastoma – GBM – postoperative MRI

Case 6

Hemangioblastoma – preoperative MRI
Hemangioblastoma – postoperative MRI

Case 7

Hemangioblastoma preoperative CT+ , with craniectomy that was made in an other institution
Hemangioblastoma – Postoperative day 1 MRI

Case 8

Meningioma – preoperative MRI
Meningioma – postoperative MRI

Case 9

Optic nerve pilocytic astrocytoma – preoperative MRI
Optic nerve pilocytic astrocytoma – postoperative MRI

Case 10

Low grade glioma – preoperative planning MRI
Low grade glioma – postoperative MRI

Case 11

Craniopharyngioma – preoperative MRI
Craniopharyngioma – endoscopic trans nasal-trans sfenoidal resection – postoperative MRI

Case 12

Brainstem secondary melanoma that failed the radiosurgery treatment – preoperative MRI
Brainstem secondary melanoma that failed the radiosurgery treatment – 2 years postoperative MRI

Case 13

Posterior interhemisferic approach for a right carrefour cerebral metastasis

Case 14

Meningioma pre and postoperative MRI

Case 15

choroid plexus papilloma – pre and postoperative MRI

Case 16

Cerebral metastasis – preoperative MRI
Cerebral metastasis – postoperative MRI

Case 17

Epidermoid cyst – pre and postoperative MRI

Case 18

Early recurrence of a glioblastoma operated in an other institution – pre and postoperative MRI

Case 19

Falx cerebri meningioma – preoperative MRI
Falx cerebri meningioma – postoperative MRI

Case 20

Vestibular schwannoma – pre and postoperator MRI

Case 21

Meningioma pre an postoperative CT+

Case 22

Meningioma – pre an postoperative MRI

Case 23

Low grade glioma pre and postoperative MRI

Case 24

hypophysis macroadenoma – preoperative MRI
hypophysis macroadenoma – postoperative MRI

Case 25

Glioblastoma – post and preoperative MRI

Case 27

Tuberculum sellae meningioma preoperative and postoperative MRI

Keyhole neurosurgery video – by NeuroHope

Pontine melanoma metastase
Invazive macroadenoma
Olfactive meninigoma
Petroclival meningioma
Microadenoma – endoscopic transnasal trans sphenoidal approach