PHILOSOPHY
Neurosurgical procedures still are particularly challenging for both, patients and surgeons. Beside the risks generated by the lesion itself, morbidity caused by the surgical approach is a relevant part of this challenge.
Over the last two decades minimal invasive Neurosurgery (MIN) came up with the aim to achieve at least comparable results as standard procedures but confronts the patient with significant lower risks. This may be achieved for example by utilizing so-called keyhole approaches.
In addition, endoscopes were found to enable brilliant visualization of hidden areas of the brain also around corners or fragile neurovascular structures.
Thus, optimal results by means of this strategy require experience with keyhole approaches and endoscopic Neurosurgery. Therefore, the goal of ENDOM College is to teach this knowledge worldwide in a comprehensive way.
MINIMAL INVASIVE NEUROSURGERY (MIN)
Minimal invasive Neurosurgery (MIN) is an integral patient tailored treatment strategy. It does not simply mean to use smaller craniotomies or skin incisions. It includes beside the utilization of keyhole craniotomies also a meticulous and individual planning of the particular surgery as well as application of the latest technology.
MIN approaches are not called keyhole approaches because of the shape or absolute size of the craniotomy. They rather are call that way because of the fact, that one may well oversee all objects distant to a keyhole, even if they are much bigger than the hole itself. In contrast, even small objects very close or direct in front of a keyhole cannot be sufficiently visualized. This implies, that large but deep seated lesions such as skull base tumors or intraventricular pathologies may be perfectly visualized and treated whereas same sized lesions on the surface require openings equaling the size of the lesion itself.
ENDOSCOPIC NEUROSURGERY
The term endoscopic Neurosurgery is used basically for all procedures that are performed with the help of endoscopes. Endoscopic procedures may be performed purely endoscopic, for example for the treatment of occlusive hydrocephalus and cystic lesions or in combination with the operating microscope for example for the treatment of large tumors of the skull base or vascular lesions. The latter technique is named endoscope-assisted microsurgery (EAM). If endoscopes are used as the only optical tool but manipulations performed along the scope, it is referred to as endoscope-controlled microsurgery (ECM). This technique is recently more and more applied for transnasal skull base surgery.