gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Microsurgery and endoneurosurgery: complementary techniques for minimally invasive trans-cranial tumor surgery

Meeting Abstract

  • corresponding author U. Godano - Division of Neurosurgery, G.Brotzu Hospital, Cagliari, Italy
  • V. Meleddu - Division of Neurosurgery, G.Brotzu Hospital, Cagliari, Italy
  • G. Nurchi - Division of Neurosurgery, G.Brotzu Hospital, Cagliari, Italy
  • M. Bellinzona - Division of Neurosurgery, G.Brotzu Hospital, Cagliari, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.03.02

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Godano et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Endoscope-assisted microsurgery has become a standard tool in the neurosurgical treatment of intracranial tumors and vascular lesions. It allows minimally invasive “key-hole” approaches, thereby reducing cerebral tissue traction. These kinds of approaches are particularly suited for deep seated and small tumours of the anterior cranial fossa, the suprasellar and parasellar regions. The contribution of endoscopy to standard microsurgery is based on its ability to better identify anatomical structures under limited viewing angles and behind corners. This can be achieved with angled endoscopes in order to reduce tissue manipulation and traction. Increased experience with endoscopic techniques has allowed for more extensive application of combined microsurgical and endoscopical approaches. In particular under direct endoscopic vision, it is possible to perform many surgical manoeuvres, using specifically designed instruments passed in surgical corridors alongside the endoscope, which can be fixed on a holder. In this way it is possible to realize a transcranial bimanual endoscopic technique (that can be defined “endoneurosurgery”), which allows for dissection and manipulation of structures that are not directly visualized under the operating microscope. Endoscopy has thus become complementary to standard microneurosurgery, and both techniques can be used in different phases of the same procedure. The authors describe their experience with a combined endoscopic and microsurgical technique in 10 cases of cranial tumors: 3 craniopharyngiomas, one epidermoid tumor of the sylvian region and six meningiomas, two of the anterior fossa and four of the parasellar region. We demonstrate the technical aspects of endoneurosurgery, its advantages and limitations with the help of our video material.