Allow me to walk you through my minimally invasive approach to surgery.

Retrosigmoid Craniotomy

Retrosigmoid craniotomy is a fundamental approach in neurosurgery, providing access to the cerebellopontine angle (CPA) for treating a variety of conditions, including trigeminal neuralgia, hemifacial spasm, acoustic neuroma, meningioma, and cerebellar or brainstem lesions. Traditionally, this procedure involved a large area of hair clipping, a wide curvilinear incision, and extensive bone removal. This often resulted in increased postoperative pain and a higher risk of cerebrospinal fluid (CSF) leaks.

Minimally invasive retrosigmoid craniotomy, on the other hand, utilizes a keyhole concept with minimal shaving and a small craniotomy just large enough to accommodate an endoscope. This innovative approach offers several advantages, including enhanced intraoperative illumination, a wider angle of visualization, reduced tissue trauma, and a faster recovery time compared to traditional techniques.

Pterional Craniotomy

Pterional craniotomy is a versatile neurosurgical approach used to address a wide range of conditions, including aneurysms, metastases, gliomas, AVMs, meningiomas, and suprasellar lesions. Traditionally, this procedure involves a large incision extending from just in front of the ear to the middle of the head, resulting in significant dissection/manipulation of the temporalis muscle. This can lead to postoperative temporalis muscle wasting and discomfort.

The mini-pterional craniotomy is a minimally invasive variation that offers a less invasive option for many of these same pathologies. With a smaller incision and reduced trauma to the temporalis muscle, this technique potentially offers patients faster recovery, less postoperative pain, and improved cosmetic outcomes.

Chiari Malformation

Chiari malformation is a structural abnormality where the lower part of the cerebellum (the cerebellar tonsils) descends through the foramen magnum,the opening at the base of the skull. This can obstruct the normal flow of cerebrospinal fluid (CSF), leading to various neurological symptoms. Chiari decompression surgery aims to relieve this obstruction by removing a portion of the suboccipital bone and sometimes part of the topmost vertebra (C1). In cases where bone decompression alone is not sufficient to restore normal CSF flow, a dural expansion procedure may be performed.

Traditionally, Chiari decompression involved a large incision, extensive muscle dissection, which causes significant postoperative pain and muscle spasms. However, minimally invasive technique offers a compelling alternative involving a much smaller incision, minimal muscle disruption, and potentially less postoperative discomfort, leading to faster recovery times for patients.

Spine

Traditional spine surgery often necessitates a large midline incision and extensive mobilization of paraspinal muscles, leading to prolonged hospitalization, extended recovery, and increased pain and muscle spasms. In contrast, minimally invasive spine surgery offers a less invasive alternative, utilizing multiple small incisions and specialized retractors guided by neuronavigation. This approach minimizes trauma to the paraspinal muscles, resulting in faster recovery times, reduced postoperative pain, and less overall discomfort.