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Minimally invasive brain surgery

Spotlight Tuesday, 11 February 2020 12:00
The advantages of minimally invasive brain surgery summarised The advantages of minimally invasive brain surgery summarised

The brain is made up of a highly complex network of nerve fibres, akin to a series of interconnected tracks in the network that makes up an entire train system. If the fibre connections are disconnected, the function of the areas they are connected to, such as speech, vision or movement, will be affected. Disruptions can be caused not only by the tumour growth or blood clot itself, but also by surgical tools.

What happens in brain surgery?

In conventional brain surgery, to reach a tumour or blood clot which is located in an inner region deep in the brain requires cutting through at least some normal brain tissue. Cutting through the normal brain and the connecting fibres means increasing the risks of losing an important function. These additional risks from the impact of surgery itself often reduce, or even outweigh, the benefit of a surgery that (critically) needs to be done.

How does minimally brain invasive surgery benefits?

  • Smaller wound: Since the diameter of the minimally invasive device is no bigger than a 5-cents coin, a smaller incision is required compared to normal open surgery.
  • Less injury to brain: By using the device to go in-between the folds of the brain and along the nerve connection, brain injury from the surgery itself can be minimised.
  • Faster recovery: A smaller wound and lesser injury to the brain will help to shorten the recovery period. 
  • Safe and targeted access to deep brain tumours: With the help of advanced imaging and surgical planning tools, minimally invasive brain surgery has been shown to be a safe and effective way to reach the deep brain areas.

Has minimally invasive brain surgery been used before?

The concept of minimally invasive surgery has been around since the 1960s. In those years, delivery has been limited by the lack of appropriate surgical tools, advanced imaging, and ability to use computers to visualise brain anatomy.

Technological developments in the recent years have allowed neurosurgeons to perform brain surgery in a minimally invasive, safe and effective way. Currently available tools and software for minimally invasive brain surgery expands the type of tumours that can be operated on. In the past, these may have otherwise previously been considered inoperable or unsafe to be operated on.

Example of tumours that can benefit from minimally invasive surgery

Read more about how Dr Kon used minimally invasive approach to remove a tumour in the ventricles: External link

How is minimally brain invasive surgery performed?

  • The brain has folds and S-shaped bends, much like valleys and hills. The tube-like device enters the existing gaps between the folds and displaces the normal brain tissue to reach the deeper spot where the tumour is, as opposed to cutting through the normal brain.
  • The opening in the skin and skull is therefore reduced to a size small enough for the device to go through with a little extra space for manoeuvre.
  • Preserving the internal fibre connections is critical in preserving function. The neurosurgeon will also choose a path that is parallel to the fibre connections to minimise cutting into these. This can be achieved with advanced imaging and surgical planning tools which are used to visualise the brain connections.

What are the risks of the procedure?

As with any brain surgery, minimally invasive brain surgery has its risks and complications, which include the risks of permanent loss of functions, seizures, stroke and infection. Whether a conventional approach or a minimally invasive approach is better suited will need to be tailored to the individual’s needs.


  • Minimally invasive brain surgery is designed for smaller openings and less disruption to the brain during surgery. 
  • The technology available today gives neurosurgeons an option to make surgery for brain tumours more effective.


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