Minimally invasive approaches

Q. Do you perform minimally invasive surgery, and how do you decide when a minimally invasive approach is appropriate?

In general, we always try to use the approach to surgery in teh least invasive means possible to achieve the goals of surgery. Inthe past ten years or so, this has in practice meant an increased use of radiation (radiosurgery) and the surgical endoscope to provide panoramic exposure with a smaller craniotomy and correspondingly smaller incision. I routinely use minimally invasive approaches for some tumors, like pituitary and other anterior skull base surgeries, and selectively in lateral skull base procedures.

Importantly, radiation – in the form of stereotactic radiosurgery – may provide an effective means of treating benign tumors of the brain and spine. Radiosurgery is a critical tool in the comprehensive treatment of tumors such as acoustic neuroma, and plays a role in decision making at all times, even when it is not the appropriate first line of treatment.

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