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Neurosciences | Posted on 05/12/2020 by Dr. Amit Chakrabarty
Endoscopic Brain and Spine Surgery is a minimally-invasive surgical procedure which uses micro-incisions, specialized visualization and surgical equipment to treat a variety of conditions affecting the brain and the spine. An endoscopic brain and spine surgery is performed with the help of an endoscope – a small, flexible, light-weighted tube mounted with a camera and lights – that is inserted into the body cavity through micro-incisions to visualize various parts of the brain, skull or spine. The endoscope functions as a small microscope that provides magnified images of the target area, which helps the surgeon perform the surgery with more precision and specifically focuses on areas that need repair, removal or replacement. The aim purpose of this surgery is to solve the target problem while minimizing the damage to the surrounding tissues. An endoscopic brain and spine surgery does not require large incisions on the scalp or skull or deep cut into the brain tissue; hence, the surgery is considered much less invasive in comparison to a conventional brain or spine surgery. That said, there is no lapse of care and attention with which removal or repair of the problem is done as compared to open, conventional surgery; endoscopic surgery is as effective and is performed with the utmost care and precision as open surgery.
Moreover, with the recent advancement of medical technology, endoscopes have become more improved, smaller and much more efficient with higher resolution and brighter light. This has led to a significant transformation in brain and spine surgeries, especially intracranial problems in adults and children. Endoscopic brain and spine surgeries are being increasingly adopted due to their advantages such as below:
The goal of an endoscopic brain and spine surgery depends on case-to-case, and the problem concerned such as an eliminating tumour, biopsy, mass removal, decompression of nerve, removal of a herniated disc, or solving any other neurosurgical problem. The main agenda behind the surgery is to treat the problem effectively with minimum scarring and complications.
An endoscopic brain and spine surgery is minimally invasive and thus, tends to reach the targeted area via natural openings such as nostrils or through micro-incisions without any retraction. Once the opening is made, an endoscope – a thin, flexible tube is inserted into this opening to get visual images of the target area on the monitor. The endoscope is mounted with a high-definition camera and illuminating light to provide clear pictures. This enables the surgeon to specifically target the concerned area and perform the surgery faster, with minimum complications and scarring. The surgery is done through real-time images displayed by the endoscope on the monitor. Post this, the surgeon uses special instruments to repair, remove or replace the problem; these instruments allow for less retraction and the possibility of injury to the brain or the spine.
The risks of an endoscopic brain and spine surgery depend on the area in question. The risks of this surgery are similar to those in an open surgery; however, this surgery has a low intensity of risks in comparison since the method uses less retraction, unlike open surgery. That said, some common risks associated with the surgery include:
However, these risks are rare, and the success rates of endoscopic brain and spine surgery are very high.
A few examples of surgeries that apply the endoscopic method to treat a variety of conditions related to the brain and spine include:
Intracranial Surgery: In this type of surgery, an endoscope is inserted into the patient’s brain through a micro-incision in the skull; through which tiny instruments are placed or passed to treat and perform certain procedures such as tumour biopsy, colloid cyst resection, hydrocephalus and cyst fenestration. This procedure takes only about 15 minutes to an hour, and the patient is discharged the very next day from the hospital.
Endonasal Neurosurgery: In this surgical form, the endoscope is guided through the nose to treat a variety of conditions such as pituitary tumours, meningiomas and chordomas. This technique allows the surgeon to clearly view different areas, increasing the possibility of treatment of brain tumours in various locations. Moreover, this method also enables the surgeon to view the palate downward and check the back of the throat and conduct the procedure on top of the spine and base of the skull. The surgery is longer than intracranial surgery, and patients are usually discharged within four days.
Spinal Surgery: This form of surgery also helps to treat various spinal conditions such as lumbar and thoracic hernias, intense back pain, compression fractures, etc. However, these conditions will need further treatment support as thought appropriate by the surgeon. This surgical method is fast and straightforward, allowing the patient to be discharged the next day from the hospital.
In all, endoscopic brain and spine surgery is a result of medical advancement and even witnessing further improvements. However, the applicability of the surgery to a patient will need to be assessed by the doctor depending on the condition and the specific problem.
