Minimally Invasive Brain Surgery

Minimally Invasive Brain Surgery at Saint John's

Saint John's offers a full-circle, minimally invasive approach to brain tumor removal, referred to as the 360º Approach. Surgeons create a precise surgical corridor that minimizes manipulation of nerves, critical blood vessels, and the brain itself. Tumors can be accessed through a nostril, an eyebrow, from behind the ear or through the use of a brain port. The aim is to reduce complications and disfigurement to the patient, while promoting a more rapid, complete and less painful recovery.

The 360° Approaches

• Expanded Endonasal Approach

  Working through the nostrils without facial or scalp incisions, the EEA allows surgeons to remove skull base tumors, pituitary tumors and some brain tumors while minimizing brain and nerve manipulation. Drs. Kelly and Kassam have one of the world’s largest endonasal surgical experiences of over 2 decades and 2,000 patients treated.  Learn more »  

• Supraorbital Eyebrow Approach

   Through a small incision within the eyebrow, surgeons are able to remove tumors under or within the frontal lobes and around the pituitary gland.  Learn more » 

  Retromastoid Approach

   Through a small incision behind the ear, surgeons are able to remove tumors in the cerebellum and areas along the brainstem and skull base.  Learn more »  

  Brain Port Approach

   The port allows surgeons to reach certain hard-to-access brain tumors using a small tube and an endoscope. Dr. Kassam helped develop and refine this approach to remove tumors below the surface of the brain and in the fluid-filled chambers of the brain (ventricles).  Learn more »

• Conventional & Other Keyhole Craniotomies

  There still remains a role for conventional larger craniotomies and skull base approaches, especially when the tumor itself has created a path through the brain and bone, which can be used to optimize the corridor. In some patients, a larger bony opening may be preferable to moving a nerve or blood vessel to reach a given target.  In these instances, 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.   Learn more »  

How is the Specific Approach Selected?

The surgical approach used is determined exclusively by the specific tumor or lesion location and the individual patient anatomy. Because the minimally invasive approaches used at Saint John's are technically demanding and require specialized instrumentation, they are certainly not appropriate for all intracranial tumors. In these cases, there still remains a role for conventional larger  craniotomies  and  skull base approaches , especially when the tumor itself has created a path through the brain and bone, which can be used to optimize the corridor. In some patients, a larger bony opening may be preferable to moving a nerve or blood vessel to reach a given target. Our multidisciplinary team has a combined total of 25 years of extensive experience with conventional and minimally invasive approaches. This large experience allows the team to provide truly comprehensive care using tailored approaches best suited for each individual patient.