Overview: Minimally invasive “keyhole” and conventional approaches are used to remove tumors over the surface of the brain or within the brain. Technical advances over the last two decades have allowed these approaches to become smaller, safer and more precise. Larger craniotomies are used when the tumor itself is very large and close to the brain surface, while smaller keyhole openings can be used for smaller surface tumors and most deeper tumors regardless of size.

For both keyhole and conventional craniotomies, a preoperative surgical navigation MRI or CT scan allows the scalp incision and bone opening to be tailored to the tumor location and facilitates safe and effective removal. Functional MRI and/or MRI tractography may also be used to determine the relationship of the tumor to critical brain regions and white matter tracts. Intra-operative ultrasound is also often used to help precisely localize deeply situated brain tumors 

Disorders Treated: Keyhole and conventional craniotomies are used to remove tumors arising from the brain linings (dura) such as meningiomas as well as tumors within the brain such as gliomas (astrocytomas, ependymomas, oligodendrogliomas, intraventricular tumors) and metastatic brain tumors.

Our Experience and Approach: Dr. Daniel Kelly and the BTC team have extensive experience using keyhole and conventional craniotomies for both benign and malignant brain tumors. Because of our large experience with both minimally invasive and conventional approaches, we can determine the optimal approach for each patient.

Multidisciplinary Care: For patients with incompletely removed or aggressive brain or skull base tumors, additional treatments such as radiosurgery and/or chemotherapy may be needed. To learn more, go to Comprehensive Brain Tumor Program.

See more: Endoscopic & keyhole surgery videos on BTC YouTube Channel