A large number of neurosurgical procedures involve microscopic work. In such work, the surgeon operates with the use of a microscope which gives excellent magnification and illumination simultaneously. Delicate anatomy becomes well demonstrated making surgery safer. This has brought about a marked improvement in terms of surgical morbidity over the last 2 years or so. With the widespread use of the operating microscope, microneurosurgery has become a basic part of a neurosurgeon's core skill.

The microsurgical techniques in neurosurgery are also quite unique to the discipline as the handling of brain tissue is different from the handling soft tissue in other parts of the body. Excessive retraction of brain tissue must always be avoided while venous bleeding from the sinus (large veins in the dura or covering of the brain) can be torrential and life-threatening. The appreciation of three-dimensional anatomy is of paramount importance while positioning of the patient in the optimal position can make a world of a difference in terms of access, exposure and safety.

Neurosurgery is a demanding surgical discipline with very interesting science behind many pathologies.

When large, brain tumours are often debulked from within. This is to reduce the size of the mass so that further mobilisation of the tumour from the brain can proceed. Retraction of the brain is thus avoided.

In eloquent (important) areas, intraoperative monitoring is often required to avoid damage to these areas.

Intra-operative neuronavigation (eg, Stealth system, Brain Lab system) helps the neurosurgeon to navigate through vital structures and avoid damage to crucial strutures.