Florida Hospital Orlando’s Minimally Invasive Brain Surgery Program offers a wide variety of treatments options to our patients. Our goal is to provide the most advanced minimally invasive option available while navigating the patient through the different steps to achieve the best possible outcome.The following list includes some of the most commonly performed procedures by our physicians that could be recommended for you.
Gamma Knife® Radiosurgery
The Gamma Knife Center at Florida Hospital Orlando was established in 1996 and is the only facility of its kind in Central Florida. It is the largest and most experienced Gamma Knife program in the region. Gamma Knife® Radiosurgery is a non-invasive procedure that uses powerful doses of radiation to target and treat diseased brain tissue while leaving surrounding tissue unharmed. The accuracy of the Gamma Knife is less than 1 millimeter. The Leskell Gamma Knife® Perfexion™ produces finely focused beams of gamma radiation, maximizing accuracy, safety and patient comfort. This procedure is commonly used to treat patients with brain tumors, vascular malformations and functional disorders. It often takes less than two hours and patients are back home resuming their regular activities later that day. Patients do not need to stop their routine medications to undergo Gamma Knife. Additional benefits include no anesthesia, surgery without an incision, decreased infection risk, and average lower costs than traditional brain surgery.
Endoscopic Endonasal Skull-Base Surgery
Endoscopic endonasal skull-base surgery is a minimally invasive surgical technique performed through the nose in order to remove brain tumors, pituitary tumors, and other lesions at the base of skull. Using neuronavigation (a computer-assisted GPS-like device), an endoscopic camera less than 5 millimeters in size along with surgical equipment is inserted through the nose, allowing the surgeon to navigate to the tumor safely and remove it without any large incisions. The camera allows for greater detail when working within the small corridors of the brain and skull base. The high-definition lighting ensures there is minimal disturbance to other parts of the brain while maximizing the surgeon’s ability to visualize the area that needs to be removed or repaired. This procedure often takes less than four hours to complete and patients typically go home in one to three days. Patients who have this procedure done typically have shorter anesthesia times, improved outcomes, faster recovery, less pain, and no scars compared to traditional open brain surgery.
Endoscopic Brain Surgery
Endoscopic brain surgery is a minimally invasive surgical technique utilizing a high-definition lighting instrument connected to a camera for visualizing different regions of the brain. The endoscope itself can vary from 2mm to 5mm and can be used in conjunction with high-definition 2-dimensional or 3-dimensional cameras. Some endoscopes have working channels to insert instruments through when performing certain procedures such as brain tumor biopsies, while others are used through the nose, or through minimally invasive ports, such as the brain port. The type of endoscope used depends on the instruments needed to treat the problem. Using neuronavigation, which is GPS-like brain tracking guidance, the endoscope can be used in virtually any part of the brain using minimally invasive routes and with accuracy of less than a few millimeters. The result is improved outcomes for the patient. With advancements in endoscope and endoscope instrument design over the past decade, this technology is now allowing surgeons to treat lesions of the skull base, pituitary, pineal gland, and ventricles with smaller incisions, increased success and lower risks.
Brain Port Surgery
Brain port surgery is a minimally invasive surgical technique performed through a specially designed tube about the size of a dime. Using neuronavigation GPS-like guidance, the brain port is inserted into the brain with millimeter accuracy and is used as a channel to guide the surgeon and his/her instruments to various regions of the brain. An endoscope is inserted into the tube, providing a powerful light source and high-definition imagery of the lesion and its surrounding structures. Since the entire procedure is done through the brain port, it minimizes trauma to the brain and surrounding tissue. This technique is used often for tumors within the substance of the brain as well as those within the fluid-filled spaces of the brain such as the ventricles. Colloid cysts, metastatic tumors, and a variety of tumors within the ventricles are often candidates for this approach. The use of a port minimizes brain retraction when trying to gain access below the brain’s surface and the use of an endoscope improves illumination and visualization of the deep structures of the brain resulting in less damage to the surrounding tissue. Patients who have this procedure done typically have a faster recovery, less pain, and minimal scars compared to patients who undergo traditional open approaches.
Endoscopic Microvascular Decompression
Endoscopic microvascular decompression is a minimally invasive surgical technique done through a small incision behind the ear to treat conditions like trigeminal neuralgia, hemifacial spasm, and other forms of neurovascular compression syndromes. The neurosurgeon uses an endoscope alone to identify where a blood vessel is compressing the nerve of interest as it leaves the brainstem. The surgeon then delicately separates the blood vessel away from the nerve with a small piece of teflon felt, leaving a space in between. By doing this, the abnormal compression of the cranial nerve is relieved. Recent literature has suggested that the use of an endoscope for microvascular decompression, as opposed to a microscope alone, is more likely to identify the source of neurovascular compression and ensure that the nerve is adequately decompressed. The result is a higher percentage of patients with symptomatic relief when awakening from the procedure and a lower complication rate due to less extraction, better visualization and improved illumination.
Neuroendovascular surgery is a specialty within the fields of radiology and neurosurgery. It is a minimally invasive technique performed by threading catheters through an artery or vein, allowing the surgeon to diagnose and treat the problem without an incision. This procedure is commonly used to treat neurological disorders such as stroke, malformed blood vessels, aneurysms, and tumors. By using this technique, it offers the patient better outcomes, reduces the movement of sensitive tissues, faster recovery time, and fewer complications than conventional surgery.
Traditional Open Surgery
In addition to minimally invasive surgical approaches, our team is trained and experienced in all traditional approaches to the brain, so they fully understand all of the options available to them. This expertise allows our neurosurgeons to develop the best treatment plan for each patient, utilizing the technique or combination of techniques that offer the best opportunity for returning the patient to normal life. Although, some lesions can be treated by a MIBS approach individual characteristics of the problem relative to each patient’s anatomy may make an open approach safer or more successful. By having a team experienced in both approaches, patients are provided all the options to make an educated decision on how to manage their neurological disorder.
LITT is a minimally invasive surgical technique used often for tumors within the substance of the brain unresponsive to traditional treatments including surgery, radiation therapy, radiosurgery, and chemotherapy. LITT is a diode laser technology that uses light energy via a laser probe to irreversibly and precisely destroy tumor tissue and tissue damaged by radiation necrosis.
A relatively new technology only being offered at a handful of centers around the United States, LITT is not an upfront treatment in the management of intracranial disease, but rather is a tool currently being used for patients in whom no other reasonable option exists.
To find out what treatment option might be best for you, call (407) 303-7944 or contact us.