ISMINS: Prof. Yoko Kato

Fujita Health University, Japan

Mission statement

-To develop the basic until the advance technique of minimally invasive neurosurgery in all subspecialties

– To provide a new concept or novel technique to improve the surgical treatment

-To accomplish on effective approach towards minimal tissue traumatization, preservation of neurological function

– To support young neurosurgeons who interest in the minimally invasive surgery to train their skill

Vision statement

To promote knowledge and enhance skill of minimal invasive neurosurgery to improve the treatment outcome

Main Background

The goal of minimally invasive neurosurgery is to reduce brain or spinal tissue damage and morbidity of the procedure. Not only small surgical wound for cosmetic aspects but also minimally injury along the entry route could be achieved. For minimally invasive procedures in neurosurgery including endoscope that became a useful tool during a part of the microsurgical procedure. Interactive computer imaging with frame-based and frameless stereotaxy are increasingly being used independently and in combination in order to execute minimally invasive approaches and to navigate a safe path within the cranium or spine. Interventional neuroradiology and stereotactic radiosurgery add further dimensions to the minimally invasive approach and diminish the need for open surgery. Further more, the technique cannot completely do without adjunct of high technology that enhance the accuracy or precision of the treatment. By the way, the several advantages of minimally invasive surgery is providing a short stay after surgery, early ambulation by the patient and saving the cost during spent a short time in the hospital. However, the disadvantages should be also concerned in the under optimal treatment outcome such as inadequate obtained the tissue of a huge mass, a limitation for blood coagulation space until the accuracy of device while we approach to the depth and small area. In some procedure, the minimally invasive surgery can not obtained the sole purpose for curative especially endoscopic for pituitary tumor, we need multidisciplinary team during perform the procedure. In additionally, the interventional radiology for the giant aneurysm or large arteriovenous malformation (AVM) treatment need combined with microsurgical treatment for complete cure.

About ISMINS

The concept of minimally invasive neurosurgery was explored by Axel Pernesky in the 80s, and it was his dream to establish an international society to coordinate efforts in developing this technique. Even though he was not able to realize this dream, a group of like-minded colleagues from around the world decided to create an international scientific society that would encourage the research and development of minimally invasive techniques based on modern technologies that could reduce the risks of conventional procedures in our patients. Hence, in 2011, the International Society on Minimally Invasive Neurosurgery (ISMINS) was founded, chaired by Professor Yoko Kato from Japan.

Our society aims to develop minimally invasive neurosurgery across all disciplines, from the most basic technique to the most advanced ones. We also wish to provide new and novel concepts in improving surgical treatments and outcomes, because with minimally invasive techniques, we can accomplish effective approaches with minimal tissue traumatization, and the preservation of neurological functions. We at ISMINS make it our goal to support young neurosurgeons around the world who are interested in minimally invasive neurosurgery, to train them, to educate them, and to hone their skills.

Our vision is to promote the sharing of knowledge and the enhancement of skills in minimally invasive neurosurgery in order to improve treatment outcomes.

Background

Minimally invasive neurosurgery is aimed at minimizing brain or spinal tissue injury during surgery, hence reducing morbidity from the procedure. A small surgical wound is more cosmetically desirable, but more than that, with minimally invasive techniques, minimal injury along the surgical entry route can be achieved.

The development of advanced surgical modalities helps achieve this goal. Tools such as endoscope and interactive computer imaging with stereotaxy – both with and without frames – are used independently and in combination to navigate a safe and minimally damaging path within the cranium and spine. With the advent of interventional neuroradiology and stereotactic radiosurgery, further depth and dimensions are added to the concept of minimally invasive approaches, as well as diminishing the need for open surgery. In order to achieve this, the utilization of technologically advanced adjuncts is vital in enhancing the precision of the treatment.

Minimally invasive neurosurgery provides several advantages over the conventional technique, namely a shorter hospital stay and earlier post-operative ambulation. These in turn can reduce the cost of hospitalization for the patient. However, this technique also has its disadvantages. Inadequate sampling of a mass much larger than the surgical space provides can lead to suboptimal outcomes. The space along the path toward the surgical field is limited; achieving hemostasis can potentially be an issue. In some procedures, minimally invasive surgery may not be adequate to obtain complete resection or obliteration, hence a multidisciplinary approach can prove useful. For example, radiointervention for a giant aneurysm or a large arteriovenous malformation (AVM) is needed in combination with microsurgical treatment to achieve a complete cure.