Endoscopic and Endoscope Assisted Brain Surgery (EEA Technique)

Endoscopy is an excellent method for brain surgery that allows access to inaccessible areas of the brain where certain kinds of tumors may develop. Endoscopy and endoscope assisted brain surgery is one of the latest, safe and fast techniques that uses highly specialized instruments and a high definition endoscopic camera system.

Indications for Endoscopic and endoscope assisted brain surgery

  • Tumours on the base of skull

  • Pituitary Adenoma

  • Meningioma

  • Clival region tumor etc.

Procedure:

The procedure starts with the insertion of an endoscope through the nose. This prevents the need for incision in the skull part to access brain and also gives a better highly illuminated inverted cone magnified view of the base of skull. Usually a high-speed debrider is inserted along with the endoscope to clear the soft tissue from the surgical pathway, The base of skull is drilled using high speed medical drills to gain good exposure and in some cases as meningioma to devascularize the tumour. Thus tumors point of attachment is exposed. Both the endoscope and the instrument is used at the same time during surgery using four hand two surgeon technique of “Carrau and Kassam”. The manipulation of the endoscope provides adequate visualization of the tumor. The tumor is then removed with clear margins. After the removal, the reconstruction of the skull base is performed using vascular pedicle grafts with or without bone graft. The tissue grafts accumulated from other parts of the body may also be used for reconstruction. Tissue glue is used to hold the tissues in place.

Advantages of EEA technique

  • No incision is made on the skull or any other part of body

  • Leaves no scar

  • Surgery is initiated through natural opening such as mouth or nostril

  • Avoids pressure on the brain

  • Can treat both benign and malignant tumors

  • Facilitates highest rate of resection with minimal morbidity

  • Early discharge from hospital (2-4 days after surgery)