Minimally invasive keyhole brain surgery
Minimally invasive keyhole brain surgery is a fibre-sparing approach designed to reach deep-seated brain lesions while minimising disruption to healthy brain tissue.
Dr Nicolas Kon, senior consultant neurosurgeon at Neuro Asia Care in Singapore, applies advanced techniques such as BrainPath in carefully selected patients, focusing on precision, safety, and neurological preservation.
Key points at a glance
- A gentler way to reach the brain: Minimally invasive keyhole surgery focuses on reducing disturbance to healthy brain tissue while treating deep brain conditions.
- Fibre-sparing access: Techniques such as BrainPath separate brain fibres rather than cutting through them, helping to preserve important functions like movement, speech, and thinking.
- Careful selection is essential: Not every brain condition is suitable for a minimally invasive approach. A specialist assessment is needed to determine whether this technique is appropriate.
A precise way to reach the brain
When brain surgery is needed, the biggest question is not only what needs to be treated, but how the surgeon gets there.
Minimally invasive keyhole brain surgery is designed to reach deep problems in the brain while disturbing as little healthy brain tissue as possible. For selected patients, this approach aims to protect brain function and support recovery.
This Straits Times media feature reports on the introduction of BrainPath minimally invasive brain surgery technique in Singapore, led by Dr Nicolas Kon, senior consultant neurosurgeon in Singapore.
In 2019, Dr Kon used this fibre-sparing approach to treat a patient with a life-threatening deep brain blood clot. The case marked an early milestone in Singapore’s move toward less disruptive ways of accessing the brain, with a strong emphasis on protecting neurological function.
Today, the same principles are applied across a broader range of carefully selected brain conditions, where a gentler surgical corridor may offer meaningful benefit.
This page explains the approach in simple terms, outlines its potential benefits, and introduces the expertise behind its use in Singapore.
What is minimally invasive keyhole brain surgery?
Minimally invasive keyhole brain surgery is a surgical approach that allows surgeons to reach deep areas of the brain through a small, precisely planned opening in the skull, while minimising disruption to healthy brain tissue.
“Keyhole” refers to the use of a smaller opening than traditional surgery, with careful planning to avoid important brain pathways.
Why does surgical access matter in brain surgery?
The brain is tightly packed with pathways that control movement, speech, thinking, and sensation.
Traditional brain surgery may require passing through healthy brain tissue to reach a deep problem. Modern minimally invasive techniques focus on doing the opposite by protecting normal brain tissue wherever possible.
This is achieved by:
- Using smaller, carefully planned openings
- Gently separating brain fibres instead of cutting though them
- Reducing unnecessary disturbance to the brain
As Dr Kon explains:
“Think of the brain like an MRT network.
If you don’t slice into the fibres, you don’t damage the tracks.”
— Dr Nicolas Kon, senior consultant neurosurgeon, Singapore
In simple terms, the goal is to treat the problem while protecting as much normal brain function as possible.
What is the BrainPath technique?
BrainPath is a minimally invasive surgical tool that helps surgeons reach deep areas of the brain through a narrow, controlled corridor.
How does BrainPath work?
Instead of pushing or cutting brain tissue aside, it:
- Creates a narrow, controlled path to the target
- Gently separates the natural brain fibres
- Allows the neurosurgeon to work through this corridor
You can think of it as sliding between brain fibres rather than cutting across them. In simple terms, BrainPath helps the surgeon reach the target area without pushing aside large amounts of normal brain tissue.
BrainPath is not a treatment on its own, but a safer way of accessing the brain in selected cases.
When might minimally invasive keyhole brain surgery be used?
Minimally invasive, fibre-sparing techniques may be considered in carefully selected patients with:
- Certain deep-seated brain tumours
- Bleeding within the brain (including haemorrhagic stroke)
- Other deep brain conditions where a gentle access route is possible
Not every patient or condition is suitable. Careful specialist assessment is essential.
What are the potential benefits of minimally invasive keyhole brain surgery?
For suitable patients, potential benefits may include:
- Less injury to healthy brain tissue
- Smaller surgical openings
- Reduced manipulation of the brain
- Potentially shorter hospital stays and smoother recovery
- Better preservation of movement, speech, or thinking
Outcomes vary depending on lesion type, location, neurological status, and individual patient factors. The technique is chosen only when it is expected to offer real benefit.
Is minimally invasive keyhole brain surgery suitable for everyone?
Not all patients or brain conditions are suitable. Patients with complex or deep-seated brain lesions may benefit from early specialist assessment to determine whether this approach is appropriate.
Expertise behind the technique in Singapore
Dr Nicolas Kon is a senior consultant neurosurgeon with extensive experience in:
- Minimally invasive keyhole brain surgery
- Fibre-sparing and functional neurosurgery
- Complex brain tumours and brain haemorrhages
He led the introduction of the BrainPath technique in Singapore after specialised training and multidisciplinary collaboration.
Dr Kon practises at Neuro Asia Care and Mount Elizabeth Hospital, caring for patients with complex neurological and neurosurgical conditions. His clinical focus includes minimally invasive keyhole surgery for brain tumours and selected deep brain haemorrhage, with an emphasis on precision, safety, and outcomes that matter to patients and families.
Take-home message
Minimally invasive keyhole brain surgery focuses on how the brain is accessed, not just what is treated. By reducing disruption to healthy brain tissue, fibre-sparing techniques aim to protect brain function in carefully selected patients. Specialist assessment is essential.
