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Minimally Invasive Surgery Provides Easier Option For Some Patients

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**Sponsored by Mayo ClinicThis content is not an endorsement from the ABTA.**

Minimally invasive tumor resection

Minimally invasive tumor resection: Preoperative MRI shows a large cerebellar metastatic tumor.
Preoperative MRI shows a large cerebellar metastatic tumor.

Postoperative imaging

Postoperative imaging: Postoperative MRI shows complete resection of the large tumor. The patient went home on the day following the procedure.
Postoperative MRI shows complete resection of the large tumor. The patient went home on the day following the procedure.

Mayo Clinic is pioneering the use of minimally invasive surgery to treat brain tumors. Minimally invasive procedures allow surgeons to reach a tumor without removing a portion of the skull (craniotomy). 

Dr. Kaisorn L. Chaichana, MD, is a neurosurgeon who performs minimally invasive brain tumor surgery at Mayo Clinic in Jacksonville, Florida. 

“We have been able to surgically remove select tumors through a 14-millimeter burr hole, similar to what is used for a needle biopsy,” Dr. Chaichana says. “We believe a minimally invasive approach can be used for select lesions without affecting the extent of tumor removal.”

Dr. Chaichana, Mayo Clinic
Dr. Kaisorn L. Chaichana, MD, Mayo Clinic

Patients usually go home the day after burr hole surgery.

“A minimally invasive approach means patients heal faster, so they can start radiation and chemotherapy sooner, if needed,” Dr. Chaichana says.

Mayo Clinic has successfully performed burr hole surgery on patients with metastatic brain tumors as well as low- and high-grade gliomas. The procedure is typically used for tumors that measure four centimeters or less and are located close to the brain’s surface.

The key to the burr hole approach is a visualization tool known as an exoscope. It greatly enhances the neurosurgeon’s view of the tumor and surrounding brain.

“The exoscope hovers over the surgical field, not within the cavity. It provides a wider focus of view, greater magnification and oblique visualization angles,” Dr. Chaichana says.

Another minimally invasive procedure, known as a keyhole craniotomy, is suitable for certain patients with large olfactory-groove meningiomas. “The potential advantages include minimizing the brain manipulation that’s needed to reach the tumor, and lower risk of sinus damage and cerebrospinal fluid leaks,” Dr. Chaichana says.

As a center of excellence, Mayo Clinic can provide minimally invasive surgery for skull base tumors. One such procedure — known as endoscopic endonasal approach — offers better tumor removal and vision preservation for certain people with craniopharyngiomas. It also offers advantages for certain patients with pituitary adenomas. 

“Endoscopic endonasal is a more complex approach. Having extensive surgical experience and vast neuroanatomy knowledge is essential,” Dr. Chichana says.

Minimally invasive brain tumor surgery is an example of how Mayo Clinic uses advanced skill and technology to benefit patients. “Our goal always is to achieve maximal, safe resection,” Dr. Chaichana says. “When appropriate, a minimally invasive approach can also make treatment easier for patients.”

Picture of Jessie Schlacks

Jessie Schlacks

Jessie is Managing Editor of the bi-monthly e-newsletter MindMatters. Submit story ideas or questions to jschlacks@abta.org.