The technique involved in the surgery uses keyhole (small) incisions in the skull followed by inserting slim instruments like endoscope through the hole and then remove the entire bone flap. This bone flap is temporarily removed and then replaced after the surgery has been done. This bone flap heals repairs like any other broken bone after surgery. Just like cast in broken arms or legs, the surgeons sometimes use metallic plates to hold the bone flap in its place.
Endoscopic Craniotomy is also known by the following names:
Craniotomy is often confused with Craniectomy in which bone flap is removed like craniotomy but is not replaced like craniotomy. It may be because of injury or infection to the bone itself. In such cases, artificial bone and prosthetics are used.
The surgery is performed by making a small incision in the skull. After that burr holes are made in the skull and then a bone flap (piece of bone) is taken out to get an access to the brain. Now the surgeon can perform the required procedure, be it relieving the pressure on brain, removing blood clot, clipping the connection between an aneurysm and a blood vessel, or removing part of or whole tumor.
Once the surgery is done, the surgeon replaces the bone flap and then stitches the scalp together. Usually bone flaps are fixed at their place with the help of a metal plate or metallic screws in order to prevent the dislocation of bone flap.
This surgery takes 4 to 6 hours including the time of giving anesthesia before surgery and shifting of patient to ICU after surgery. Patient stays in ICU or recovery area for regular intensive monitoring. Depending on the recover rate, patient then gets shifted to ward where nursing team is available for close monitoring and taking medical care. Patient is given fluid intake initially through drips. There is also a drain pipe attached for removing any kind of fluid coming out from wound. Also, till the patient starts moving, a catheter is put into bladder for passing urine. All these tubes get removed one by one as the patient recovers.
Patient might feel pain and tightening at the site of wound as it recovers. The treating doctor gives pain killers for this pain to subside. It would gradually go away once the stitches are removed after few days of surgery.
Patient may also feel a clicking sensation at the surgical site. This is due slight movement of bone flaps and so there is no need to get worried as it is not harmful. The flap will heal in sometime and then the patient would get relieved of this sensation. There can be mild headache for few months; this too would settle dwn over a period of time.
The hospital stay varies from 3 to 7 days.
Recovery time depends upon certain factors like:
Following are the precautions to be taken during recovery period:
This includes both general and specific risks. General risks are: infection at the surgical site, blood clot or bleeding, instability of blood pressure, and pneumonia. While specific risks can be: brain swelling, stroke, coma, meningitis, seizures, imbalance while walking, and memory problems.
Like we said for other surgeries, here too all the above can be avoided by pre discussion with your treating doctor and following the instructions completely.
The treating doctor needs to be contacted in case of below mentioned issues: