International expert consensus statement about methods and indications for keyhole microneurosurgery from International Society on Minimally Invasive Neurosurgery

Microneurosurgery made its debut in the early 1960s. It became popular quickly in the medical field and soon became a primary method in neurosurgery, as it improved the efficacy of neurosurgery, reducing surgically related injuries. Over the past five decades, the accumulation of microsurgery experience, improvements in microsurgical techniques, refinement of microinstruments, and advanced preoperative diagnostic imaging have enabled the evolution of microneurosurgical techniques and the further reduction of surgery-related trauma. These advancements have made it possible for neurosurgeons to treat more complicated lesions via smaller craniotomies [ 35 , 60 ]. Keyhole neurosurgery, a combination of modern microsurgical techniques, preoperative imaging, neuroendoscopy, and the modern concept of minimally invasive surgery, is a technique representing the medical advances from microneurosurgery to minimally invasive neurosurgery [ 19 , 63 , 88 ].