Weill Medical College of Cornell University

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Minimally Invasive (Endoscopic) Surgery Overview

• Minimally Invasive Surgery Overview
• Arachnoid Cysts
• Cerebrospinal Fluid Leaks
• Chordomas and Chondrosarcomas, neuro-oncology
• Colloid Cyst
• Craniopharyngioma
• Dural Arteriovenous Malformations (AVMs)
• Pineal Region Tumors
• Pituitary and Parasellar Tumors
• Spinal Arteriovenous Malformations

Endoscopic neurosurgery is the technique of using a tube with a lens and a light source to look into a body cavity through a small opening. Endoscopes look like small telescopes but are actually more like small microscopes since they allow illumination and visualization of objects up close rather than far away. Endoscopic techniques are now widely used in medicine. Colonoscopy, laparoscopy, arthroscopy, bronchoscopy, and thoracoscopy are all performed using endoscopes.

Endoscopic neurosurgery has greatly simplified the management of many intracranial ailments in adults and children. Similar in concept to other endoscopic surgery, intracranial neuroendoscopy reduces the surgical morbidity, shortens the hospital stay, and minimizes the cosmetic concerns associated with many major neurosurgical conditions.

In general, neuroendoscopy does not require large incisions on the scalp, removal of skull flaps, or extensive dissection through brain tissue. In the past several years the technological advancements in endoscope design have been substantial. A reduced size, improved resolution, and brighter illumination of the endoscope has allowed the benefits of endoscopic surgery to be applied in neurosurgery.

Neurosurgeons originally used endoscopes several decades ago; however, use was limited. Recently, due to technological improvements and a drive towards less invasive surgical procedures, the use of endoscopy has expanded in neurosurgery. Endoscopes may be introduced into the brain through small holes (as little as 3 millimeters) drilled in the skull. Tiny instruments can then be placed through the same hole as the endoscope to treat hydrocephalus, drain cysts, and biopsy tumors. Spinal surgery may also be performed endoscopically in certain cases. Procedures may be performed under local or general anesthesia and patients often go home in as little as on day.