Brain Surgery
நுண் துளை மூளை அறுவைசிகிச்சை 🧠
Dr. Rajkumar explains advanced endoscopic and microsurgery techniques for complex neurological conditions without traditional scalp incisions.
Watch on YouTube →Procedures
Neurosurgery Procedures at KG Hospital
From the world’s first paediatric MINS to complex skull base and cerebrovascular surgery — we perform the complete spectrum without the need to travel to a metro city. MINS and Trigeminal Neuralgia have dedicated deep-dive pages — highlighted below.
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Minimally Invasive Neurosurgery (MINS)
World’s First — ETV · Skull base endoscopy · CSF rhinorrhea · Corpus callosotomy · Paediatric MINS
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KG Hospital achieved a global landmark: the world’s first Minimally Invasive Neurosurgery on a 22-day-old premature infant — the youngest MINS patient ever recorded globally. MINS uses small cranial access points, Stryker Neuronavigation, and the TIVATO 700 microscope to reach deep brain structures with minimal disruption — less blood loss, shorter stays, faster recovery versus open craniotomy.
World’s First — KG Hospital
- World’s first MINS on a 22-day-old premature infant — youngest MINS patient ever reported globally, performed at KG Hospital, Coimbatore
- ETV (Endoscopic Third Ventriculostomy) — shunt-free hydrocephalus treatment via tiny endoscope
- Endoscopic skull base surgery — trans-nasal access to pituitary, craniopharyngioma, clival tumours
- Endoscopic corpus callosotomy — minimally invasive epilepsy surgery for drug-resistant drop attacks
Benefits vs open craniotomy: smaller incision, less blood loss, less brain retraction, shorter stay (3–5 days vs 7–10), faster recovery
ETV: shunt-free hydrocephalus treatment — preferred over VP shunt when anatomy is suitable
Endoscopic skull base: trans-nasal access to pituitary adenomas, craniopharyngiomas, clival tumours — no external incision
CSF rhinorrhea repair: skull base leak sealed endoscopically — typically 1-night stay
Corpus callosotomy: for drug-resistant epilepsy with drop attacks — faster recovery vs open approach
Paediatric MINS: including the world’s first on a premature infant — expertise for the most complex paediatric presentations
Dedicated Deep-Dive Page
Minimally Invasive Neurosurgery — Complete Patient Guide
All MINS procedures. Candidacy criteria. What to expect. Recovery timeline. The World First story. Technology used.
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Brain Tumour Surgery — Open & Keyhole (MINS)
Glioma · Meningioma · Acoustic neuroma · Pituitary adenoma · Skull base · CP angle · Thalamic · Brainstem
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KG Hospital performs brain tumour surgery for the complete range of intracranial tumours — including thalamic tumours, brainstem lesions, and skull base lesions that most hospitals refer to metro centres. The TIVATO 700 microscope provides fluorescence imaging (5-ALA for glioma), while Stryker Neuronavigation gives GPS-precision guidance throughout. For tumours near speech or motor areas, awake craniotomy is performed.
Tumours treated: glioma (all grades), meningioma, acoustic neuroma, pituitary adenoma, skull base, CP angle, posterior fossa, thalamic, brainstem, intraventricular, insular gliomas, metastases
TIVATO 700: fluorescence-guided resection (5-ALA) shows tumour vs normal brain in real time
Stryker Neuronavigation: 3D intraoperative guidance throughout the procedure
CUSA: safe tumour debulking without damaging surrounding brain tissue
Stay: typically 5–7 days open; 3–5 days MINS approach
Post-op: dedicated Neuro ICU with intensivists
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Awake Craniotomy
Eloquent cortex tumours · Insular gliomas · Language & motor mapping · Epilepsy focus near functional areas
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Awake craniotomy is brain surgery performed with the patient awake during tumour removal, allowing real-time monitoring of speech, language, and motor function. This ensures maximum safe resection without causing neurological deficits. KG Hospital performs awake craniotomy as part of an integrated team including specialist neuroanaesthesiologist trained in awake-sleep-awake technique.
Indicated for: tumours in speech areas (Broca’s, Wernicke’s), motor strip, supplementary motor area, insular cortex
Cortical mapping: performed intraoperatively — surgeon maps functional boundaries before each resection step
Patient: sedated for opening and closing — awake only during the critical resection phase
Goal: maximum safe resection — extent of resection is the strongest predictor of glioblastoma survival
Team: specialist neuroanaesthesiologist + neuropsychologist + neurosurgeon required
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Cerebrovascular Surgery — Aneurysm, AVM & STA-MCA Bypass
Aneurysm clipping · Endovascular coiling · AVM excision · STA-MCA bypass · Moyamoya disease
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KG Hospital treats brain aneurysms (ruptured and unruptured) with microsurgical clipping and endovascular coiling via the Biplanar Neuro Cath Lab. Moyamoya disease — a progressive condition causing recurrent strokes — is treated with STA-MCA revascularisation bypass under the TIVATO 700 microscope using 1–2mm sutures.
Ruptured aneurysm: surgical emergency — clipping or coiling within 24–72 hours prevents catastrophic re-bleeding
Aneurysm clipping: microsurgical — clip permanently excludes aneurysm from circulation
Endovascular coiling: via Biplanar Cath Lab — same-session diagnosis and treatment without open surgery
AVM excision: complete surgical removal is curative — permanently eliminates haemorrhage risk
STA-MCA bypass: scalp artery anastomosed to brain artery to restore blood flow in Moyamoya
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Deep Brain Stimulation (DBS) — Parkinson’s, Tremor & Dystonia
Parkinson’s disease · Essential tremor · Cervical dystonia · Stereotactic electrode implantation
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DBS implants electrodes into specific deep brain targets using millimetre-precise stereotactic guidance. An implanted pulse generator delivers continuous stimulation, dramatically reducing tremor, rigidity, and dyskinesia. KG Hospital is among the few centres in South India actively performing DBS — a multidisciplinary team of movement disorder neurologist and functional neurosurgeon selects and manages candidates.
Ideal candidate: Parkinson’s patient with good levodopa response but motor fluctuations or inadequately controlled tremor
Microelectrode recording (MER): identifies optimal target in real time during surgery
Two stages: lead implantation, then IPG placement 2–4 weeks later
Post-operative programming: stimulation fine-tuned non-invasively as disease evolves
Also for: essential tremor, cervical dystonia, generalised dystonia
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Trigeminal Neuralgia Surgery — MVD, Glycerol & Radiofrequency
Microvascular Decompression (MVD) · Glycerol rhizotomy · Radiofrequency thermal lesioning · Facial pain
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Trigeminal Neuralgia causes sudden, severe, electric shock-like facial pain triggered by eating, speaking, or light touch — one of the most painful conditions in medicine. The primary cause is a blood vessel compressing the trigeminal nerve in the posterior fossa. Microvascular Decompression (MVD) is the gold-standard surgical treatment with 80–90% long-term pain-free rate and preservation of facial sensation.
MVD (gold standard): 80–90% long-term pain-free rate · Facial sensation preserved · Under TIVATO 700 microscope
Glycerol rhizotomy: percutaneous injection · Outpatient · 80% pain relief · May need repetition
Radiofrequency lesioning: selective nerve fibre destruction · 3–4 years relief · Some facial numbness expected
MRI first: identifies compressing vessel and excludes MS or tumour as cause
Medications first: carbamazepine or oxcarbazepine — surgery when these fail
Dedicated Deep-Dive Page
Trigeminal Neuralgia — Complete Patient Guide
Symptoms, causes, and every treatment option explained. MVD vs Glycerol vs Radiofrequency. Recovery and success rates.
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Epilepsy Surgery — Resection, Corpus Callosotomy & Awake Mapping
Drug-resistant epilepsy · Temporal lobectomy · Lesionectomy · Corpus callosotomy · Video-EEG evaluation
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For drug-resistant epilepsy (approximately 30% of patients), surgery can offer seizure freedom. KG Hospital performs a full pre-surgical evaluation — video-EEG monitoring, high-resolution MRI, and neuropsychological assessment. Options include temporal lobectomy (70–80% seizure freedom for mesial temporal lobe epilepsy), lesionectomy, and endoscopic corpus callosotomy. Awake craniotomy is used when the focus is near eloquent cortex.
Pre-surgical: long-term video-EEG, 3T MRI epilepsy protocol, PET/SPECT, neuropsychological testing
Temporal lobectomy: 70–80% seizure freedom for mesial temporal lobe epilepsy
Lesionectomy: removes cavernoma, cortical dysplasia, or low-grade tumour causing seizures
Endoscopic corpus callosotomy: for drop attacks — minimally invasive vs open callosotomy
Paediatric: hemispherotomy for hemispheric epilepsy in children also performed
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Spine Surgery — Disc, Stenosis, Fusion, Deformity & Tumour
Discectomy · Laminectomy · TLIF/PLIF · ACDF · Scoliosis · Spinal cord tumour · Arnold Chiari · TB Spine · MISS
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KG Hospital’s spine programme handles the complete range — from lumbar disc prolapse to complex deformity correction, spinal cord tumours, and CV junction anomalies. Minimally invasive spine surgery (MISS) is used wherever appropriate. Stryker navigation with C-arm fluoroscopy ensures accurate pedicle screw placement. Intraoperative neurophysiological monitoring (IONM) protects the spinal cord throughout all complex procedures.
Lumbar/cervical/dorsal discectomy: MISS approach standard for suitable cases
Spinal fusion (TLIF, PLIF, ACDF): for instability and spondylolisthesis
Scoliosis and kyphosis: navigated instrumented fusion restoring spinal alignment
Arnold Chiari + syringomyelia: posterior fossa decompression allowing syrinx resolution
Also: spinal cord tumours (intradural + extradural), TB Spine, spinal trauma, meningomyelocele, tethered cord, CV junction anomalies
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Paediatric Neurosurgery
Hydrocephalus · ETV · Meningomyelocele · Tethered cord · Craniosynostosis · Paediatric brain tumours
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KG Hospital performed the world’s first MINS on a 22-day-old premature infant — demonstrating extraordinary paediatric neurosurgical capability. Hydrocephalus is treated with VP shunting or ETV (preferred shunt-free option). Meningomyelocele repair is performed within 48 hours of birth. Tethered cord, craniosynostosis, and paediatric brain tumours (cerebellar astrocytoma, medulloblastoma, ependymoma) are regularly treated.
World’s First — Paediatric MINS
- World’s first MINS on a 22-day-old premature infant — youngest MINS patient ever recorded globally, at KG Hospital, Coimbatore
Hydrocephalus: VP shunt and ETV — ETV preferred for obstructive hydrocephalus to avoid life-long shunt dependency
Meningomyelocele: emergency closure within 48 hours of birth to prevent infection and maximise neurological outcome
Tethered cord: release prevents progressive neurological deterioration and bladder dysfunction
Craniosynostosis: endoscopic strip craniectomy for eligible infants
Paediatric tumours: cerebellar astrocytoma, medulloblastoma, ependymoma, optic pathway glioma
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Traumatic Brain Injury & Emergency Neurosurgery
Intracranial haematoma · EDH · SDH · Skull fracture · Brain contusion · ICP management
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KG Hospital’s 24/7 emergency neurosurgery team is equipped to rapidly assess (128-slice CT) and operate on patients with intracranial haemorrhage, raised ICP, or herniation syndromes at any hour. Emergency procedures include EDH and SDH evacuation, intracerebral haematoma drainage, and depressed skull fracture elevation. Post-operative critical care in the dedicated Neuro ICU.
EDH (epidural haematoma): arterial bleed — surgical emergency; evacuation within 1–2 hours is lifesaving
Acute SDH: venous bleed over brain surface — evacuation within 4 hours associated with best outcomes
Chronic SDH: common in elderly — burr hole drainage; often full recovery
ICP monitoring: in severe TBI patients in the dedicated Neuro ICU
128-slice CT: available 24/7 — no imaging delays at any hour
Emergency: call 0422-2222222 immediately for any head injury with deterioration