BrainCare International S.A was founded in 1997 and registered in Luxembourg. The mission is to provide the best care to patients who are suffering from brain and spinal cord disorders.
The purpose also of the company is the provision of consultancy services in the Health sector with particular reference to Neurology and Neurosurgery, Minimal invasive neurosurgery, Neuroanaesthesia and Pain management, Neuroendoscopy. The company can undertake all transactions pertaining to the taking of participating interests in any enterprise having directly or indirectly similar objectives and dealing with the management, control and development of these participating interests.
It may use its funds for the setting-up, the management, the development and the disposal of a portfolio consisting of any securities and patents of whatever origin, participate in the creation, the development and the control of any enterprise, to acquire by way of investment, subscription, underwriting or by option to purchase and any other way whatever securities and patents, to realize them by way of sale, transfer, exchange or otherwise. Grant to the companies in which it has participating interests any support, loans, advances or guarantees.
The Company may also undertake any commercial, industrial, and financial transaction, which it might deem useful for the accomplishment of its purpose including the participation and organization of medical conventions and congresses. The company may also participate in various scientific research and development programs in the field of medical and pharmaceutical industry including distribution and commercialization of their products.

The board of directors is medical doctors, financial managers and health care managers dedicated to our mission and scope.

Our medical staff are leading medical doctors in their specialty bringing together the best innovative technics in neurology and neurosurgery and the state of the art medical instrumentations in a collective environment for healthcare beyond borders in select areas of Europe, where multilingual services of the highest standard are offered.

BrainCare International has over twelve doctor and surgeon members who visit Europe on an ongoing rotation basis, in order to perform the brain and spine operations. Our doctors apply innovative surgical techniques using methods of Minimally Invasive Spine surgery, which in most cases allow the patient to leave the hospital the same day of surgery.

The last year, BrainCare International are merged with a Hellenic company Neuroiasis LTD and was created a new Hellenic company named BrainCare Hellas. The company also starts cooperation with a Cypriot medical company named Tzanis Spyridon IEPE and has developed a new project for the medical tourism in neurosurgery.

Transnasal transsphenoidal approach to pituitary tumors has provide excellent surgical results with low morbidity and mortality. Many ENT surgeons are also present excellent surgical results in endoscopic nasal sinus operations. The last year many authors have reported initial results in combining these approaches.

During the transsphenoidal approach for total resection of the adenomas the lesion or portions of this may be hidden behind unretractable structures. For example, parts of the adenomas may be infiltrated the cavernous sinus, or may be attached underneath the optic nerve and the optic chiasm. Use the endoscope’s to visualize those structures can avoid the risk of inadverted injury and can help to remove the hidden adenomas into the cavernous sinus.

The last year we use the endoscope’s as assist to microsurgical resection of the pituitary microadenomas and macroadenomas. Technical details of this approach are discussed and illustrated cases are presented. We also present the postoperative endocrinological evaluation in our cases and we compare our result with previous cases, which was operated without endoscopes.

copyright © 2001-2002

The advantages of the endoscopic pituitary surgery include the excellent visualization of the pituitary gland and its surrounding structures through a small operative approach. It also permits a direct look into the surgical field with broad lateral vision and possibility of movements not limited by the tunnel created by the transphenoidal speculum. If the surgeon decides that operative conditions warrant conversion to a standard transphenoidal approach he can safely and rapidly accomplish this. The potential for tumors removal is greater and the tumor tissue- gland and gland-diaphragm distinction are easier, as better identification of holes in the cisterns can be achieved. Early surgical results are equivalent to those of standard transphenoidal procedures, with excellent postoperative course and minimal immediate respiratory difficulties. It optimize the outcome of the patients with reduction of postop discomfort, hospitalization times and costs.

Endoscopic Advantages

1. Excellent visualization

2. Conversion to standard approach

3. Identification of holes in the cisterns

4. Distinction between normal tissue –adenoma and gland-diaphragm

The problems and limits related to the endoscopic approach are essential as follow

1. endsoscopy requires a blood-free surgical field. Careful attention must be paid to the initial decongestant treatment of the nasal mucosa. Furthermore it is possible to rapidly turn to the microscopical procedure if a profuse arterial bleeding which for any reason cannot be managed. Packing is virtually all one can do at that time.

2. The 3-D view provided by microscope is completely different and better than is given by endoscope but the global vision offered by the endoscopy permits an overview and a panoramic view directly into the anatomy. In the nasal and sphenoidal phases the reduction of the visual depth in comparison to the microsurgical approach, is eliminated by the continuous up and down movements of the endoscope which allow to surgeon to fix the landmarks as known in nasal sinus surgery. The 3-D view provided by microscope is completely different and better than is given by endoscope.

3. This approach which offers a wider operating field can only be performed with instruments used for conventional transphenoidal surgery.

Problems and Limits

Endoscopy requires a blood-free surgical field

The 3-D view provided by microscope is completely different and better than is given by endoscope.

This approach can only be performed with the instruments used in conventional transphenoidal surgery

FINAL CONSIDERATIONS

• Endoscopic approaches in pituitary surgery can provide surgical results equivalent to standard transeptal transphenoidal approach with less perioperative discomfort and sorter hospital days.
• It is not safe to perform the wide range neuroendoscopic procedures without a preliminary complete microsurgical training.