Minimally invasive pediatric neurosurgery
Our surgeons have fellowship training—additional preparation and experience comes after the completion of a specialty-training program such as neurosurgery—in both pediatric neurosurgery and minimally invasive neurosurgery. This makes our pediatric neurosurgery program one of only a few in the nation whose surgeons have fellowship training in all areas.
Many brain tumor operations that traditionally required a large scalp incision and large opening in the skull (craniotomy) now are performed with minimally invasive surgery. We use highly specialized instruments that allow us to make smaller incisions, which means less time spent in surgery, less postoperative pain, a faster recovery, minimal to no hair shaving, and less visible scarring.
Small keyhole craniotomies for removal of brain tumors
For certain tumors deep under the surface of the brain, a very small and narrow surgical opening can be used to reach the tumor. This minimizes damage to normal brain tissue overlying the tumor. Use of intraoperative stereotactic neuronavigation—computer-assisted technology used during an operation to help guide a neurosurgeon within the confines of the skull—helps determine the trajectory to the tumor. With this procedure, incisions are linear (not curved) and typically 1 to 2 inches long.
Eyebrow incision for removal brain tumors
For certain tumors, access to the brain and removal of the tumor can be accomplished with a small incision in the eyebrow. The incision is hidden in the eyebrow and heals quickly without a visible scar.
This minimally invasive surgical technique uses a specialized endoscope—a long, thin, tube-like instrument—with a high-resolution video camera to perform brain surgery. Smaller incisions and openings in the skull often result in less pain and shorter hospital stays.
Neuroendoscopy can be used to treat a variety of conditions. An endoscope can be used to assist keyhole craniotomy surgeries or used by itself to treat colloid cysts and other tumors or masses in the ventricles (fluid filled spaces) of the brain. An endoscope can also be used through the nose to treat pituitary tumors, craniopharyngiomas, rathke cleft cysts, or other tumors at the base of the brain. An endoscope also is used to treat hydrocephalus—a buildup of fluid in the brain—by performing a cyst fenestration or endoscopic third ventriculostomy (ETV). Endoscopy also is now being used to treat complex Chiari malformations—structural defects in which part of the brain pushes down onto the spinal cord at the base of the skull—that present with basilar invagination (narrowing of the opening in the skull where the spinal cord passes through to the brain) by allowing decompression of the top of the spine.