Keyhole Approaches in Neurosurgery
A. Perneczky, R. Reish (eds.)
2008, 310 pp.; 644 figures; 16 tabs.
Text: English
Hardcover EUR 299.00 (net price)
CHF 521.00; USD 439.00; GBP 209.00


The first volume of the monograph by Prof. A. Perneczky, the world-famous European grandee of minimum-invasive neurosurgery, is devoted to foundations of keyhole surgery, being the most popular and claiming trend of modern medicine. Minimum invasiveness is a corner-stone of up-to-date neurosurgery. There are a lot of studies, aimed at development of this trend. Neurosurgical microanatomy is an important part of research in this field.

The book is a brilliant illustration of purposeful development of this new medical technology and transition from an idea, which demanded thorough study of applied aspect of the CNS anatomy and introduction of necessary microsurgical instruments and magnifying optical devices, to results, i.e. maximum possible reduction of a traumatic character of operations with preserving a required degree of their efficacy.

The first volume gives detailed description of some modern neurosurgical approaches. They include supraorbital, subtemporal, retrosigmoid, suboccipital and interhemispheric accesses, used in a wide spectrum of neurosurgical pathology. Description of keyhole approaches, performed in tumors of a pineal region, lateral and third ventricles, is of peculiar interest.

All approaches are described in a step-by-step manner with detailed discussion of all technical aspects, including optimum dissection technique, possible errors and their consequences, technical nuances, facilitating different stages of operation. Each approach is richly illustrated by diagrams, anatomic views and operative microphotographs, demonstrating consistency of the conception of a minimum bone access.

The monograph is not an atlas. It is intended for reading.

At the same time, it should be noted, that this popular trend of neurosurgery is not a dogma. Thus, neurosurgeons in general and beginners in particular should regard some suggestions of the authors with certain criticism or scepsis. Besides, one should remember, that operation via a minimum approach can be performed only is case of adequate equipment of an operating room, including endoscopic devices and special microsurgical instruments. As for our home public health system, this technology can be used only in a limited number of medical establishments.

Summarizing the aforesaid, it should be emphasized, that Keyhole Approaches in Neurosurgery (vol. 1) contains rather interesting information on a burning problem of modern neurosurgery. It is useful for those studying and practicing neurosurgery, meets all the goals of literature for postgraduate education and can be recommended for training of neurosurgeons-residents.