• Xiao Di, Alan Sui, Rodolfo Hakim, Maode Wang, and Jan Peter Warnke.
• Department of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA.
• Pediatr Neurosurg. 2011 Jan 1;47(5):315-26.

Background/AimsMinimally invasive neurosurgery is a growing field, more so in recent decades. The modernization of tools, especially the endoscope, has allowed for critical improvements and crucial advancements in minimally invasive neurosurgery. The current classification scheme for endoscopic procedures needs to be updated to reflect these advancements.MethodsAlthough the field of neuroendoscopy is continually evolving, the terminologies utilized to describe endoscopic procedures reflect and favor its use as mostly an assisting device complementing the microscope. Even though the classification was adequate for its time, it has become inexact and therefore confusing. We therefore propose a new classification scheme that encompasses the growing independence of endoscopic minimally invasive neurosurgery (EMIN) as well as the changing landscape within EMIN procedures.ResultsWe have classified our EMIN procedures, since 2002, as either 'intraendoscopic' (IEN) or 'extraendoscopic' (XEN) in relation to the endoscope's axis. Exemplary cases of IEN and a review of the literature are presented as well.ConclusionOur proposed classification scheme for solely endoscopic procedures is presented. The role of the endoscope as an independent tool is clarified.Copyright © 2012 S. Karger AG, Basel.

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