Is it possible to remove intracranial tumors without opening the skull? For the past, it was unbelievable, but now at any time the development of modern minimally invasive surgery technology and the continuous application of high-tech means, such a myth is becoming reality step by step. Shanghai First People’s Neurosurgery Department, under the leadership of Director Meiqing Lou, has cooperated with the Minimally Invasive Neurosurgery Center (JOE Neurosurgery Institute) in Pittsburgh, USA for 5 years of continuous cooperation and exploration in the field of minimally invasive, through the application of neuronavigation, endoscopy, ultrasound suction and Doppler technology, the coveted removal of brain tumors through surgery without craniotomy has been realized in some brain tumors, and it can be achieved The spectrum of diseases in which this approach is possible is expanding. The diseases that can be completely solved without craniotomy are: 99% of pituitary tumors, 99% of craniopharyngiomas, chordomas, most saddle node meningiomas, anterior skull base tumors, olfactory cell tumors and intraorbital tumors, tumors of the inferior temporal fossa; tumors of the slope, etc. Most other tumors can be removed through tiny openings in the skull and brain, with bone windows about the size of a dollar coin, and through the natural gaps in the skull. For example, tumors in the deep brain, auditory neuroma, tumors in the pontocerebellar horn and cerebellar curtain, and falx of the brain contain most of the intracranial tumors. This surgical approach can bring great benefits to patients, such as no wounds on the head and face, no abnormalities in appearance, the surgery is done as if it was not done, and because the incision is made in the nasal cavity, the patient is less traumatized, the patient is comfortable, the patient is less worried, and the postoperative recovery is fast. The following are some examples of patients’ surgeries: Case 1: Tang X, male, 28 years old, with impaired consciousness, bilateral vision loss leading to blindness, and a huge pituitary tumor growing inside the skull, invading the supra-saddle and three ventricles and causing hydrocephalus. It has been 3 years since the patient returned to work normally. For more details, please check CCTV-10 “Blindness, the Death Note”. Case 2: Yuan X, a 35-year-old male with progressive vision loss leading to near blindness, had a huge intracranial craniopharyngioma, which was removed by craniotomy in a sister hospital 4 months ago. The patient recovered his vision and was cured. His case can be found in CCTV-13 news “Why he signed the organ donation agreement twice to give back to the society” Case 3: Zhou X, male, 50 years old, was unintentionally found to have an intracranial tumor about 125px in size growing from the anterior skull base into the nasal cavity during nasal examination. The patient recovered very well in 5 days after surgery and could walk out of bed, almost the same as without surgery. Case 4: Lin X, male, 31 years old, was admitted to the hospital for 2 months for wheelchair weakness of the extremities. MR examination suggested that there was a huge chordoma on the upper slope, and because the tumor was hard and the brainstem and other centers had been severely compressed, traditional surgery was not only traumatic but also extremely risky.