At our practice in Johannesburg, the use of keyhole surgical techniques is at the heart of what we do. Dr Christos Profyris adopted keyhole surgery techniques very early on in his career and undertook further dedicated specialist training in the form of a fellowship under Professor Charles Teo who is a pioneer in the field of Minimally invasive Neurosurgery.


The philosophy for a keyhole craniotomy is such that the skin incision and size of the bone removed (craniotomy) is the smallest possible that is required in order to safely remove a tumour or address a lesion.  The basic steps in performing the craniotomy are similar to those discussed under “Brain Tumour Resection” however, attention is directed to performing a small craniotomy and thereby exposing less brain than what is needed.

Depending on the position and depth of a tumour, many operations are performed through skin incisions of 5 centimetres or less. Technologies such as the neurosurgical microscope, endoscopy, neuronavigation, tractography (DTI) and ICG all aid in helping keep the craniotomies small and safe.

Keyhole neurosurgery can be done from different positions known as approaches, which depends on the location of the tumour or area in need of surgery. The following are some of the more common approaches that can be used to access various areas of the brain through only a small incision:

  • Supraorbital Eyebrow Approach
  • Endonasal Endoscopic Approach (through the nostrils)
  • Extended Endonasal Approach (through the nostrils)
  • Mini-Pterional Approach
  • Retromastoid Approach (behind the ear)
  • Gravity-Assisted Approaches
  • Brain Port Approach
  • Endoscopic Trans-Ventricular Approach

After careful consideration of your brain tumour by Dr Christos Profyris and his team in Gauteng, the appropriate keyhole approach will be selected.  Dr Profyris is experienced in removing tumours such as meningioma, low grade glioma, astrocytoma, glioblastoma, acoustic neuroma, pineal region tumour, medulloblastoma, ependymoma and many other types of tumours through these keyhole approaches.


Keyhole surgery techniques have the following advantages:

  • Shaving of very little hair
  • Execution of targeted brain surgery through the smallest possible opening – you benefit from meticulous pre-operative preparation for your case that is required for keyhole surgery
  • Minimal trauma/exposure of the healthy tissues
  • Quicker recovery
  • Shorter hospital stays
  • Superior cosmetic results
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