Minimally Invasive Neurosurgery

MINS — KG Brain & Spine Centre
KG Brain & Spine Centre — Coimbatore

World’s First MINS
on a 22-Day-Old
Premature Infant

Minimally Invasive Neurosurgery at KG Hospital Coimbatore — a global landmark achieved nowhere else. Brain surgery through small access points using the TIVATO 700 microscope and Stryker Neuronavigation. Smaller incisions. Less blood loss. 3–5 day stay versus 7–10 days for open craniotomy.

MINS vs Open Craniotomy — Key Differences
Feature MINS Open Craniotomy
Cranial access Small keyhole Large craniotomy
Hospital stay 3–5 days 7–10 days
Full recovery 2–4 weeks 6–8 weeks
Brain retraction Minimal Significant
Blood loss Much less Higher
Post-op pain Significantly less Greater
World’s First MINS on a 22-day-old premature infant — see full story ↓
World First
22 Days Youngest MINS patient ever — premature infant, KG Hospital
Hospital Stay
3–5 Days typical stay vs 7–10 for open craniotomy
Technology
TIVATO 700 Advanced surgical microscope with fluorescence imaging

What Is Minimally Invasive
Neurosurgery (MINS)?

Minimally Invasive Neurosurgery (MINS) is an approach to brain surgery that uses small cranial access points, advanced neuronavigation, and specialised instruments — including the brain endoscope — to reach deep brain structures with minimal disruption to the surrounding brain tissue. The core principle is the same as minimally invasive surgery in other specialties: achieve the same surgical result through a smaller entry point, causing less trauma.

In contrast to traditional open craniotomy — which requires a large flap of skull bone to be removed to access the brain — MINS procedures access the brain through a small keyhole opening, or in endoscopic cases, through the natural corridors of the skull (the nostril, or a tiny burr hole) with a camera and working channel. The surgeon visualises the operative field on a high-definition monitor, guided by the Stryker Neuronavigation System and the TIVATO 700 advanced surgical microscope.

KG Hospital has demonstrated the full potential of MINS by performing it on the youngest patient ever — a 22-day-old premature infant — a global first that no other neurosurgical centre had achieved.

Key Advantages Over Open Craniotomy
Smaller cranial access — minimal disruption to brain tissue
Significantly less blood loss — reduced transfusion requirement
Hospital stay 3–5 days vs 7–10 days open craniotomy
Full recovery 2–4 weeks vs 6–8 weeks for open surgery
Less post-operative pain — reduced analgesia requirement
Lower risk of brain retraction injury

MINS Procedures
at KG Hospital

KG Hospital performs the following minimally invasive and endoscopic neurosurgical procedures. Each avoids the need for large open craniotomy in most cases.

01

Endoscopic Third Ventriculostomy (ETV)

Shunt-free treatment for obstructive hydrocephalus. A small endoscope creates an opening in the floor of the third ventricle to restore CSF flow. Preferred over VP shunt when anatomy is suitable — avoids life-long shunt dependency and shunt revisions.

02

Endoscopic Skull Base Surgery

Trans-nasal endoscopic resection of pituitary adenomas, craniopharyngiomas, clival chordomas, and olfactory groove meningiomas. No external incision. Camera and instruments passed through the nostril to access skull base lesions.

03

Keyhole Brain Tumour Resection

Selected brain tumours — particularly deep-seated lesions and posterior fossa tumours — resected through a small keyhole craniotomy using TIVATO 700 microscope and Stryker Neuronavigation guidance.

04

Endoscopic Corpus Callosotomy

Minimally invasive disconnection of the corpus callosum for drug-resistant epilepsy with drop attacks (atonic seizures). Faster recovery and less morbidity versus open callosotomy, while achieving comparable seizure reduction.

05

Endoscopic CSF Rhinorrhea Repair

Sealing of skull base cerebrospinal fluid leaks through the nasal passage under endoscopic guidance. The leak site at the skull base is identified and repaired without external incision. Typically a 1-night stay procedure.

06

Intraventricular Tumour Excision

Endoscopic access and excision of tumours located inside the brain ventricles (colloid cysts, choroid plexus tumours, ependymomas) without open craniotomy. High-definition endoscope provides direct visualisation of the ventricular system.

07

Craniosynostosis Correction

Endoscopic strip craniectomy for premature fusion of skull sutures in infants. Corrects head shape and prevents brain compression as the brain grows. Minimally invasive approach suitable for selected infant cases.

08

Paediatric MINS

Complete paediatric MINS programme — from hydrocephalus and ETV to the world-first case performed on a 22-day-old premature infant. The most demanding paediatric neurosurgical cases accepted and performed.

World First

The World’s First:
MINS on a 22-Day-Old Premature Infant

KG Hospital’s neurosurgery team performed the world’s first Minimally Invasive Neurosurgery on a 22-day-old premature infant — a landmark that had never been achieved at any neurosurgical centre anywhere in the world. This was not simply the youngest MINS patient in India — it was the youngest MINS patient ever recorded globally.

1
World’s First MINS on a 22-Day-Old Premature Infant
A premature infant — just 22 days old and medically fragile — required urgent neurosurgical intervention. KG Hospital’s team performed Minimally Invasive Neurosurgery using the TIVATO 700 advanced surgical microscope and Stryker Neuronavigation. The procedure was successful. No other neurosurgical centre in the world had previously performed MINS on a patient this young. This achievement established KG Hospital as a global leader in paediatric and minimally invasive neurosurgery.
2
Why This Was Extraordinary
Operating on a 22-day-old premature infant presents challenges entirely unlike adult or older paediatric neurosurgery. The anatomy is miniature and delicate. Physiological tolerances for blood loss, anaesthesia, and temperature are extremely narrow. The brain tissue is at the most vulnerable stage of development. The Stryker Neuronavigation system had to be adapted for a premature skull. Every instrument, technique, and monitoring protocol required modification for a patient this small and this young.
3
What This Means for Patients at KG Hospital Today
The team that achieved this world first brings that same standard of precision, preparation, and willingness to push the boundaries of what is safe and possible to every neurosurgical case at KG Hospital. Whether a complex adult skull base tumour, a paediatric hydrocephalus case, or a routine ETV — the depth of expertise demonstrated by this world first is available to every patient who comes to KG Hospital in Coimbatore.

Who Is a Candidate
for MINS?

Not every brain condition requires or benefits from a minimally invasive approach — some conditions are better treated with open craniotomy. A detailed pre-operative MRI and neurosurgical assessment is essential. Below is a general guide to candidacy:

✓ Good Candidates for MINS
Obstructive hydrocephalus with anatomy suitable for ETV (avoids life-long shunting)
Pituitary adenomas and craniopharyngiomas accessible via trans-nasal endoscopic approach
Skull base tumours (clival chordoma, olfactory groove meningioma) where endoscopic access is feasible
CSF rhinorrhea — cerebrospinal fluid leaking through the nose
Intraventricular tumours (colloid cysts, choroid plexus tumours) accessible endoscopically
Drug-resistant epilepsy with drop attacks (corpus callosotomy via endoscope)
Craniosynostosis in selected infants eligible for endoscopic strip craniectomy
Selected deep-seated brain tumours where keyhole approach provides adequate access
→ Open Surgery May Be Preferable
Large tumours requiring extensive resection beyond endoscopic reach
Communicating hydrocephalus (ETV is less effective; shunt preferred)
Very large pituitary adenomas with significant suprasellar extension requiring wide exposure
Tumours requiring awake craniotomy for cortical mapping (language / motor areas)
Ruptured aneurysms requiring emergency open clipping
Complex cerebrovascular surgery (AVM, STA-MCA bypass)

Note: even when full MINS is not possible, keyhole and endoscopy-assisted approaches may reduce the size of craniotomy needed. Our neurosurgeon will advise on the best approach for your specific situation.

Your MINS Patient Journey
at KG Hospital

From consultation to discharge, here is what a typical MINS patient journey looks like at KG Hospital Coimbatore. Timelines vary depending on the specific procedure.

1
Consultation & MRI Review
Your neurosurgeon reviews your MRI (and CT where relevant) to determine whether MINS is appropriate and which specific technique will be used. For endoscopic cases, the anatomy of the ventricular system or skull base is assessed for suitability. A plan is made and explained clearly.
Day 1 — OPD consultation, 45–60 minutes
2
Pre-operative Assessment
Blood tests, anaesthesia assessment, and any additional imaging (high-resolution CT, MRI tractography for fibre tracking in tumour cases). For Stryker Neuronavigation-guided procedures, the MRI is uploaded and the surgical trajectory is planned on the navigation system before entering the operating theatre.
1–2 days before surgery
3
Surgery Day
MINS procedures range from 1–2 hours (simple ETV, CSF rhinorrhea) to 4–6 hours (complex keyhole tumour resection). General anaesthesia with neuroanaesthesia protocols. Stryker Neuronavigation is registered and verified before the first incision. The TIVATO 700 microscope is positioned. The procedure is performed.
1–6 hours in theatre depending on procedure
4
Post-operative Neuro ICU / HDU
All major MINS patients recover in the dedicated Neuro ICU or High-Dependency Unit under intensivist monitoring. Neurological observations are performed every 1–2 hours. For most endoscopic procedures, patients are mobilised on day 1 post-operatively.
First 12–24 hours post-surgery
5
Ward Recovery & Mobilisation
Transfer to dedicated neurosurgery ward. Physiotherapy input where needed. Post-operative MRI (for tumour cases) to assess resection extent. Headache (common and expected) managed with simple analgesia. Most patients eating and mobile within 24 hours of surgery.
Days 1–3 post-surgery
6
Discharge & Follow-up
Most MINS patients are discharged within 3–5 days. Discharge advice, medications, and a follow-up appointment (typically at 2 weeks and 6 weeks) are arranged before leaving. Full return to normal activities in 2–4 weeks depending on procedure. Driving typically resumed at 4–6 weeks.
Day 3–5 — discharge home

Technology Behind
MINS at KG Hospital

MINS is only as good as the instruments and imaging that support it. KG Hospital’s neurosurgery operation theatre is equipped with the following technology specifically for minimally invasive and endoscopic neurosurgical procedures.

TIVATO 700 Advanced Surgical Microscope
State-of-the-art neurosurgical microscope providing exceptional optical clarity, fluorescence imaging (5-ALA) for identifying residual tumour tissue, and ICG angiography for real-time vascular imaging. Used in all keyhole and open cranial procedures.
Stryker Neuronavigation System
GPS-precision intraoperative guidance — the surgeon sees exactly where every instrument is relative to the pre-operative MRI in real time. Critical for planning and executing keyhole trajectories safely through small access points.
Brain Endoscope System
Advanced rigid neuroendoscope for ETV, intraventricular procedures, skull base surgery, and CSF rhinorrhea repair. High-definition camera with working channel for irrigation, instrumentation, and biopsy. Eliminates the need for large craniotomies in many cases.
CUSA — Cavitron Ultrasonic Surgical Aspirator
Ultrasonic device that selectively fragments and aspirates tumour tissue while sparing surrounding normal brain and blood vessels. Essential for safe tumour debulking during keyhole procedures where operating space is limited.
Medtronic & Stryker Drill Systems
High-speed precision cranial drill systems for creating the smallest possible craniotomy or burr hole entry for MINS procedures. Aesculap and Codman micro-instruments for the most delicate intracranial dissection within the keyhole corridor.
3T MRI & 128-Slice CT — Available 24/7
Pre-operative MRI provides the 3D dataset uploaded to Stryker Neuronavigation for surgical planning. Post-operative imaging assesses resection extent and identifies early complications. Available round the clock — no delays in imaging.
FAQ

MINS Questions,
Answered

Still have questions? Call our neurosurgery team at 0422-2219191.

What is the world first achievement of KG Hospital in MINS?
+
KG Hospital performed the world’s first Minimally Invasive Neurosurgery on a 22-day-old premature infant — the youngest MINS patient ever recorded globally. This required the TIVATO 700 advanced surgical microscope, Stryker Neuronavigation, and extraordinary surgical precision to safely operate on a patient this young and fragile. It established KG Hospital as a global leader in paediatric and minimally invasive neurosurgery.
What is MINS and how does it differ from open brain surgery?
+
MINS uses small cranial access points, advanced neuronavigation, and specialised instruments to reach deep brain structures with minimal disruption. Compared to open craniotomy: smaller incisions, significantly less blood loss, reduced brain retraction, shorter hospital stay (3–5 days vs 7–10), faster recovery (2–4 weeks vs 6–8 weeks), and less post-operative pain. Not all conditions are suitable — a neurosurgical assessment determines the best approach.
What MINS procedures does KG Hospital perform?
+
KG Hospital performs: Endoscopic Third Ventriculostomy (ETV) for hydrocephalus, endoscopic skull base surgery (pituitary adenoma, craniopharyngioma, clival tumours), CSF rhinorrhea repair, endoscopic corpus callosotomy for drug-resistant epilepsy, intraventricular tumour excision (colloid cysts, choroid plexus tumours), craniosynostosis correction, keyhole brain tumour resection, and paediatric MINS including the world-first on a 22-day-old premature infant.
What is Endoscopic Third Ventriculostomy (ETV) and when is it used?
+
ETV is a minimally invasive treatment for obstructive hydrocephalus. A small endoscope is passed through a tiny skull hole to create an opening in the floor of the third ventricle, allowing CSF to flow without a shunt. ETV is preferred when anatomy is suitable as it avoids life-long shunt dependency and the risk of shunt malfunction and revision surgeries. Most ETV patients are discharged within 2–3 days.
Who is a candidate for MINS at KG Hospital?
+
Good MINS candidates include: obstructive hydrocephalus for ETV, pituitary adenomas and skull base tumours suitable for endoscopic trans-nasal approach, CSF rhinorrhea, intraventricular tumours, drug-resistant epilepsy with drop attacks, craniosynostosis in selected infants, and selected deep-seated tumours. A pre-operative MRI review and neurosurgical consultation determines suitability. Call 0422-2219191 to arrange an assessment.
How long is recovery after MINS at KG Hospital?
+
Most MINS patients are discharged in 3–5 days. Full recovery: endoscopic procedures (ETV, CSF rhinorrhea) 1–2 weeks; keyhole brain tumour surgery 2–4 weeks. This compares to 7–10 days in hospital and 6–8 weeks recovery for traditional open craniotomy. Patients are typically mobile within 24 hours of surgery.
What technology does KG Hospital use for MINS?
+
KG Hospital uses: TIVATO 700 advanced surgical microscope (fluorescence imaging for glioma, ICG angiography for vascular surgery), Stryker Neuronavigation System (GPS-precision guidance), Brain Endoscope (for ETV, skull base, and intraventricular procedures), CUSA (Cavitron Ultrasonic Surgical Aspirator), Medtronic and Stryker drill systems, and 3T MRI + 128-slice CT available 24/7 for pre- and post-operative imaging.
How do I book a MINS consultation at KG Hospital Coimbatore?
+
Call 0422-2219191 or 0422-4042121 for a neurosurgery OPD appointment. Bring your most recent MRI with report. For urgent or emergency cases — call 0422-2222222 (24/7). Our neurosurgery team will review your imaging and determine the most appropriate surgical approach.

Neurosurgical Emergency? Call Immediately.

24/7 neurosurgery emergency team on standby. Sudden severe headache, head injury, loss of consciousness, acute weakness — call now. Every minute matters.