Minimally invasive neurosurgery in pediatric practice: achievements and limitations

Abstract

Minimally invasive neurosurgery (MINS) has gained significant importance in pediatric practice in recent decades. This area of medicine is aimed at reducing tissue injury, reducing hospital stay and reducing postoperative complications, which is especially important for children with their vulnerable anatomy and physiology. One of the methods used in MINS is neuroendoscopy. This method allows for interventions on the brain and spinal cord with minimal incisions. An important achievement is the endoscopic third ventriculostomy, which is used to treat hydrocephalus. This method has become an alternative to traditional bypass surgery. The use of catheters and microspirals for embolization of aneurysms or malformations avoids open operations on brain vessels and significantly reduces the risk of complications such as bleeding and infections. Intraoperative neuronavigation systems and robotic manipulators increase the accuracy of intervention, which is especially important when working with a small volume of the cranial cavity in children. Laser methods make it possible to remove tumors with high accuracy without damaging the surrounding tissues. Ultrasound aspiration helps to destroy dense tumors safely and effectively. However, the use of MINS in pediatrics has a number of limitations. Children have thinner and more fragile tissues, which increases the risk of complications even with minimally invasive interventions. In addition, the growth of the body requires taking into account further changes in anatomy, which complicates the planning of operations. MINS requires high-tech equipment, which is not available in all medical institutions, especially in developing countries. Despite the wide possibilities, some diseases of the central nervous system, such as large tumors or complex malformations, still require open surgery. The success of minimally invasive interventions depends on highly qualified specialists and continuous training in new techniques. Not all neurosurgeons have the necessary skills to work with children within the framework of the Ministry of Health. Thus, minimally invasive neurosurgery in pediatrics has significant achievements and potential for further development, however, there are certain limitations associated with the anatomical features of children, the complexity of technology and the availability of equipment.

Imprint

Ulyana A. Ulanova, Said-Magomed A. Osmanov, Magomed S. Aliev, Valeriia Yu. Kerdivar. Minimally invasive neurosurgery in pediatric practice: achievements and limitations. Cardiometry; Issue 33; November 2024; p.63-70; DOI: 10.18137/cardiometry.2024.33.6370; Available from: https://www.cardiometry.net/issues/no33-november-2024/minimally-invasive-neurosurgery