What is
It?
"Keyhole Surgery" is a general term when steps are taken by the
surgeon to minimise the disruption and thus damage to surrounding
tissues in performing an operation, the medical term is minimally
invasive, or minimal access surgery
The advantages are the recovery from surgery is more rapid, there
is less damage to suurounding tissues and thus a lower complication
rate, and the incision is smaller. This allows patients to be
mobilised more rapidly after surgery, and thus be discharged from
hospital sooner.
An example of this in another speciality would be a laparoscopic
(telescopic) removal of a gallbladder due to gallstones
How can these techniques be applied to neurosurgery?
Because of the nature of neurosurgical operations neurosurgeons
have practiced minimally invasive surgery for many years. Use of
the operating microscope and intraoperative XRays were early
examples of the application of these techniques. Recently there
have been some technological advances that have allowed even less
invasive operations to take place, some examples of this
include:
Microdiscectomy of the lumbar spine
Microforamenotomy of the lumbar and cervical spine
Endonasal Transsphenoidal surgery for pituitary tumours
Image guided surgery
More recently still these techniques have been refined further
allowing:
Minimally invasive microdiscectomy
Minimally invasive microforamenotomy of the cervical and lumbar
spine
Endoscopic pituitary and skull-base surgery (using a
telescope)
Minimally invasive spinal fusion including pedicle screw
fixation
Mini-craniotomy for intracranial tumours using image guided surgery
techniques