Over the last ten years the department of neurosurgery at SRRSH has experienced considerable growth. The physician staff is now composed of eleven doctors, six attending, three fellows and one resident. Some of our most advanced services include neuro-navigation, stereotactic instrumentation and neuro-endoscopic surgery. Scientific research is also a very important emphasis in our department.

Micro-invasive neurosurgical technique, which refers to the use of the least invasive method possible, was applied first by our department in Zhejiang province. To teach this technique to doctors in other hospitals we have held five seminars.

Neuro-navigation is done using a neuro-navigation Surgiscope. This instrument was purchased in the year 2000 and is the only one in Zhejiang province. This state-of-the-art instrument allows the surgeon to combine diagnostic techniques, stereotactic and microscopic surgery. This process starts with accurate preoperative localization of the lesion and guides the surgeon in planning the best operative path, thus reducing injury and improving cure rates.

Stereotactic and functional surgery allows instruments to be accurately placed in unique positions deep in the brain through skull holes for the treatment of Parkinson¡¯s disease and hyperkinetic syndrome of childhood and also for the purpose of removing foreign bodies or hematoma as well as taking a biopsy.

In neuro-endoscopic surgery, lesions in the ventricle of the brain can be removed more easily with less danger to the surrounding tissues. This technique can also be used to deal with many other diseases such as aneurysm, tumor and spinal cord disease.

The term keyhole surgery refers to the use of very small holes in the skull through which endoscopy and microscopic procedures can be done in the treatment of meningioma, craniopharyngioma, aneurysm and other conditions.

Five areas of service are particularly important in this department. First is the care of severe head trauma. Our team seeks to match the best quality of international care in this area and makes use of the newest techniques such as hypothermia, endoscopic percutaneous gastrostomy and percutaneous tracheostomy.

The second area of emphasis is the combined use of advanced techniques in intracranial tumors. This is where spiral CT, functional MRI, neuronavigation, neuroendoscopy, stereotatic equipment, supra-selective chemotherapy, trans-superficial temporal artery chemotherapy, linear accelerator and gamma-knife treatments are brought together as necessary to give the best possible result to each patient. In some cases this requires close cooperation with other departments and in one case resulted in successful laparoscopic resection of a retroperitoneal schwannoma, the first such case in China and only the sixth reported such case in world literature.

Third is the treatment of cerebral vascular diseases. In these cases early diagnosis using digital subtraction angiography (DSA) and magnetic resonance imaging (MRA) are especially useful. These tools allow us to successfully complete complicated operations such as clipping of an aneurysm, resection of intracerebral arterio-venous malformations, excision of memingeal arterio-venous fistula, excision of spinal vascular malformations and intracerebral cavernous hemangiomata. In some cases the operative procedure is preceded by endovascular therapy and radiotherapy.

Fourth is the application of functional neurosurgery. Deep brain stimulation (DBS) is the best choice for the patient of Parkinson¡¯s disease. With stereotactic control, electrodes are placed around some of the nuclei deep in the brain. The electrodes are connected to an electrical stimulator which is placed in the subcutaneous tissues of the chest. This greatly relieves the symptoms of tremor and muscle tetany, thereby improving the quality of the patient¡¯s life. This particular service is not available elsewhere in Zhejiang province.

The fifth area of emphasis is in the treatment of congenital and inflammatory diseases of the central nervous system. For this condition we have carried out endoscopic third ventriculostomy, which is recognized as the best choice for obstructive hydrocephalus.