At the Saint John’s NSI-BTC every case is individually assessed by our multidisciplinary team and whenever possible one of the 360 Minimally Invasive brain surgery approaches is selected. In some situations, the tumor is located behind critical structures (nerves, brain and blood vessels) so that a minimally invasive approach is not appropriate. In these selected number of cases, a conventional craniotomy or skull base approach is an alternative option. Despite these conventional approaches requiring larger incisions, they can allow the surgeon to reach the tumor without moving a nerve or blood vessel potentially improving outcomes.

Today, craniotomies are less invasive than craniotomies of the past. Although a somewhat larger approach is needed, surgical navigation (like GPS for the brain) allows the scalp incision, muscle dissection and bony opening to be precisely tailored to the specific target in a “keyhole” fashion. Intra-operative ultrasound also provides precise real-time target localization for tumors under the brain surface. Such precision approaches further minimize tissue trauma and brain retraction while facilitating a more rapid, less painful recovery.

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