Endoscopic Brain Surgery

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Things you need to know

What is Endoscopic Brain Surgery ?

Why do you need Endoscopic Brain Surgery ?

Endoscopic brain surgery is indicated for:

Pituitary tumors: Most common, via transsphenoidal approach (through the nasal cavity and sphenoid sinus) to remove tumors like pituitary adenomas.
Ventricular lesions:
- Hydrocephalus: Endoscopic third ventriculostomy (ETV) creates a new CSF pathway to bypass blockages.
- Colloid cysts: Removal of cysts in the third ventricle causing CSF obstruction.
Skull base tumors: Meningiomas, craniopharyngiomas, or chordomas in hard-to-reach areas.
Intraventricular tumors: Ependymomas or other tumors within the brain’s ventricles.
Cerebral cysts: Arachnoid cysts or other fluid-filled lesions causing pressure.
Biopsy: Sampling deep brain lesions when open surgery is too risky.
Other: Rarely, for hematoma evacuation or treating infections (e.g., brain abscess).

The procedure aims to remove or treat the lesion with minimal brain manipulation, reduce recovery time, and lower complication risks compared to open surgery.

Why Do Endoscopic Brain Surgery Costs Vary in Philippines?

Endoscopic Brain Surgery Procedure

Before Surgery Evaluation:
- Diagnosis:
  - MRI or CT scan maps the lesion’s location, size, and relation to critical structures (e.g., optic nerve, brainstem).
  - Hormone testing (pituitary tumors): Assesses prolactin, cortisol, or thyroid levels for functional adenomas.
  - Neurological exam evaluates deficits (e.g., vision loss, headaches).
  - Blood tests ensure fitness for surgery (e.g., coagulation, hemoglobin).
- Medications: Steroids (e.g., dexamethasone) reduce brain swelling; hormone replacement (pituitary cases) if needed.
- Consent: Risks, including CSF leak or infection, are explained.
Surgical Techniques:
- Transsphenoidal Endoscopic Surgery (for Pituitary Tumors):
  - Performed under general anesthesia, lasting 2–4 hours.
  - The endoscope is inserted through one nostril, guided through the nasal cavity and sphenoid sinus to the pituitary gland (at the skull base).
  - The tumor is removed using micro-instruments (e.g., curettes, suction); the sella (pituitary housing) is repaired with a fat graft or synthetic material to prevent CSF leak.
  - No external incision; nasal packing may be placed for 1–2 days.
- Endoscopic Third Ventriculostomy (ETV):
  - For hydrocephalus, lasting 1–2 hours.
  - A small burr hole (1–2 cm) is made in the skull (usually right frontal region).
  - The endoscope accesses the third ventricle, and a small hole is made in its floor to allow CSF to bypass the obstruction (e.g., aqueductal stenosis).
- Endoscopic Intraventricular Surgery:
  - For colloid cysts or tumors, lasting 2–3 hours.
  - A burr hole allows the endoscope to enter the ventricle; the lesion is removed or biopsied.
- Intraoperative Tools:
  - Neuronavigation: GPS-like system for precision.
  - Endoscopic ultrasound: Visualizes deep structures.
  - Intraoperative MRI: Rarely used to confirm resection (pituitary tumors).
After Surgery:
- ICU or ward monitoring for 1–3 days; hospital stay of 2–5 days.
- Pain management: Analgesics (e.g., paracetamol) for headache or nasal discomfort (transsphenoidal).
- Nasal care (transsphenoidal): Avoid blowing nose for 2–4 weeks; saline rinses to clear crusting.
- Hormone monitoring (pituitary): Blood tests for cortisol, thyroid levels; temporary hormone replacement (e.g., hydrocortisone) if needed.
- Follow-up MRI/CT at 1–3 months to assess resection or CSF flow (ETV).

Recovery After Endoscopic Brain Surgery

Hospital Stay: 2–5 days; longer (5–7 days) if complications (e.g., CSF leak).
Post-Surgery Care:
- Pain: Headache or nasal discomfort (transsphenoidal) for 1–2 weeks, managed with analgesics.
- Activity: Light walking on day 1–2; avoid heavy lifting or straining for 4–6 weeks.
- Nasal care (transsphenoidal): No nose blowing for 2–4 weeks; saline rinses; nasal congestion may persist for 1–2 months.
- Hormone monitoring (pituitary): Regular blood tests for 3–6 months; diabetes insipidus (temporary, 5–10%) managed with desmopressin.
- Neurological monitoring: For improvement in symptoms (e.g., vision, headache); deficits may take weeks to resolve.
Diet: Normal diet; high-protein foods (e.g., eggs, lentils) support healing; 2–3 liters water daily (unless diabetes insipidus restricts fluid).
Follow-Up:
- Visits at 2 weeks, 6 weeks, and 3 months; MRI/CT at 1–3 months.
- Endocrinology follow-up (pituitary) for hormone management.

Most resume normal activities in 4–6 weeks. Success rates: pituitary tumor resection (80–95% for microadenomas, 60–80% for macroadenomas); ETV for hydrocephalus (70–90% success in selected cases). Symptom relief occurs in 70–90% of patients.

Risks and Complications

Surgical Risks: Bleeding (1–3%), infection (1–3%, e.g., meningitis), CSF leak (5–10%, higher in transsphenoidal).
Procedure-Specific:
- Transsphenoidal: Nasal crusting (10–20%), loss of smell (temporary, 5%), diabetes insipidus (5–10%), pituitary dysfunction (5–10%).
- ETV: Failure to relieve hydrocephalus (10–30%), requiring shunt placement.
Neurological Complications:
- Injury to optic nerve, hypothalamus, or brainstem (1–2%): Vision loss, hormone issues, or neurological deficits.
- Seizures (1–2%), managed with medications.
General Risks: Anesthesia reactions, blood clots (DVT, <1%).
Long-Term: Tumor recurrence (pituitary: 10–20% over 10 years), CSF flow obstruction (ETV: 10–20%).

Report fever, severe headache, nasal CSF leak (clear fluid), or vision changes promptly.

Frequently Asked Questions (FAQs)

What conditions can endoscopic brain surgery treat?

Pituitary tumors, ventricular lesions (e.g., colloid cysts), hydrocephalus, skull base tumors, and cerebral cysts.

Is endoscopic surgery better than open surgery?

Yes, for suitable cases; it’s less invasive, with smaller incisions, faster recovery, and lower risk of brain damage, but it’s not ideal for all tumors (e.g., large, infiltrative).

Will I have a scar?

Minimal or none; transsphenoidal leaves no external scar; ventricular surgery leaves a small scalp scar (1–2 cm).

How soon can I resume activities?

Light activities in 1–2 weeks, normal routines in 4–6 weeks.

Is endoscopic brain surgery covered by insurance in India?

Yes, for symptomatic conditions; confirm with your provider.

Signs of complications?

Fever, severe headache, clear nasal discharge (CSF leak), vision changes, or hormonal imbalances.

Will the tumor come back after pituitary surgery?

10–20% risk over 10 years, higher for macroadenomas; regular MRI and hormone monitoring are needed.

Lifestyle changes post-surgery?

Avoid nose blowing (transsphenoidal) for 2–4 weeks, manage hormones (pituitary), attend follow-ups, and avoid heavy lifting for 4–6 weeks.

Conclusion

Looking for Best Hospitals for Endoscopic Brain Surgery

Note: we are not promoting any hospitals

We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)

click on your city and schedule your surgery now done in good hands.

City	Minimum Price (₱)	Maximum Price (₱)
Angeles City
Antipolo
Bacolod
Bacoor
Baguio
Butuan
Cagayan de Oro
Caloocan
Cebu City
Dasmariñas
Davao City
General Santos
General Trias
Iligan
Iloilo City
Las Piñas
Makati
Malolos
Manila
Muntinlupa
Parañaque
Pasay
Pasig
Puerto Princesa
Quezon City
San Fernando
San Jose del Monte
Taguig
Valenzuela
Zamboanga City

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.