[Specialties · 02]
Endoscopic Surgery
Procedures performed with a camera through a small incision. Used for chronic subdural haematoma, selected bleeds inside the brain and tumours in narrow spaces.
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Endoscopic Subdural Haematoma Drainage
In chronic subdural haematoma, access is gained through a small hole (burr hole); the clot is evacuated with an endoscope, the membranous compartments are opened and a drain is placed.
- When? When headache, imbalance or weakness develops after a minor injury in older people, or in people taking blood thinners.
- How is it done? The cavity is entered with a camera through a 1–2 cm incision; the clot is washed out and cleared, and the septa are seen and opened.
- Advantages: a wider view, more complete clearance, a lower risk of recurrence, a short hospital stay.
- Risks: recurrence, infection, seizures, acute bleeding (rare).
- Afterwards: drain for 24–48 hours, early mobilisation; follow-up with check-up CT/MRI.
Endoscopic Intraparenchymal Haematoma Drainage
In selected bleeds within the brain, the haematoma cavity is entered with an endoscope through a small craniotomy and the clot is cleared in a controlled way.
- Indications: suitable lobar haematomas, neurological deterioration; the decision is individualised when the bleed is deep or close to vital centres.
- Technique: a navigation-guided corridor, minimal retraction, continuous irrigation and haemostasis.
- Benefits: less tissue retraction, shorter operating time and intensive care stay.
- Limitation: it is not suitable for every bleed; the structure and location of the haematoma are decisive.
- Risks: rebleeding, infection, seizures, neurological deficit (case-specific).
- Afterwards: intensive care monitoring, careful management of blood pressure and clotting parameters.
Endoscope-Assisted Tumour Surgery
By adding an endoscopic view to microsurgery, residual tumour in narrow spaces (the ventricular system, skull base, deep fissures) can be seen more safely.
- Areas of use: masses within the ventricles, skull base tumours, narrow surgical windows.
- Benefit: less retraction, visualisation of blind spots, a higher chance of total resection.
- On its own? Mostly combined with the microscope; depending on the case, purely endoscopic techniques are also possible.
- Safety: supported by neuronavigation, intraoperative neuromonitoring and intraoperative imaging.
Frequently asked questions
- 01Is endoscopic surgery suitable for everyone?
- No. The method is chosen according to the location and size of the lesion and how close it is to blood vessels/functional areas.
- 02How long is the hospital stay?
- In subdural cases most patients stay 1–3 days; for tumours/ICH (intracerebral haemorrhage) it is longer, depending on the case.
- 03Is there a risk of recurrence?
- Yes, especially in chronic subdural haematoma. Regular imaging and clinical follow-up are important.