A pioneering keyhole operation performed through the eye socket is offering patients with brain aneurysms the prospect of a durable, permanent cure while eliminating the most invasive and dangerous elements of traditional brain surgery, neurosurgeons in Leeds have said.
A Return to Work in Record Time
Andrew Wood, a 61-year-old builder from West Yorkshire, was back at work just a few weeks after undergoing the procedure in February 2026, having spent only a single night in hospital. His brain aneurysm—a potentially fatal swelling in a blood vessel—was discovered entirely by chance during a scan for an unrelated medical issue in the spring of 2025. “I was shocked. I didn’t have any symptoms whatsoever,” Mr Wood said. The discovery placed him in a high-stakes position: while the aneurysm had not ruptured, the consequences of a rupture are catastrophic, with a 40 per cent chance of death and a 66 per cent chance of some level of brain damage for survivors.
Navigating the Brain Without Touching It
In a standard craniotomy, surgeons would have sawed open a section of his skull and physically retracted the brain to reach the aneurysm. This approach carries inherent risks, including stroke, seizures, infection, and a small risk of death, alongside significant scarring and a typical hospital stay of one week. Instead, a team at Leeds Teaching Hospitals NHS Trust accessed the aneurysm through a small incision at the side of the eye and a cut in the outer wall of the eye socket. This UK-first procedure, described as “minimal access surgery” or “keyhole surgery”, allowed direct access to the blood vessel without touching the brain itself. “This meant that we could directly access the aneurysm without even having to touch the brain,” said Consultant Neurosurgeon Asim Sheikh, who led the surgery alongside Consultant Neurosurgeon Kenan Deniz and Consultant Maxillofacial Surgeon Jiten Parmar.
Engineering Out the Morbidity
The defining achievement of the operation lies in how it removes the surgical drawbacks typically inseparable from a definitive cure. Traditional clipping—placing a metal clip across the neck of the aneurysm—is the gold standard for durability but has always demanded the trauma of a craniotomy. This new approach severs that link entirely. “And that means he can get the best of both worlds of the surgical treatment of his aneurysm – the best possible, durable cure for his aneurysm while cutting down on the drawbacks of having surgery including big cuts and scars, big incisions on the head and also the morbidity of going through the brain and retracting the brain – all that is completely taken away by this minimal access surgery,” Mr Sheikh explained.
The morbidity associated with brain retraction has been designed out of the procedure. By using the natural anatomical corridor of the eye socket, surgeons can place the clip on the aneurysm without disturbing or compressing delicate brain tissue. The recovery timeline reflects this advance: Mr Wood returned to his physically demanding job as a builder in May 2026, a recovery unimaginable with open surgery. “I’m in the building trade so the way it was explained to me was: you can do something causing minimum damage and get the same result. I thought it was great,” he said. The meticulous preparation underpinning the operation involved biomechanical engineers creating a bespoke 3D-printed model of Mr Wood’s eye socket, skull base anatomy, and the aneurysm itself, allowing the surgical team to rehearse the complex manoeuvre tailored to his specific anatomy.
Context of a Rapidly Advancing Field
The Leeds operation builds on a similar UK-first achieved by the same team in 2024, when they removed a brain tumour through a patient’s eye socket. It represents a broader shift in neurosurgery toward techniques that combine the durability of open surgery with the recovery advantages of endovascular therapy. While endovascular methods—such as coiling, stenting, flow-diverting stents, and the WEB device—have become standard since the International Subarachnoid Aneurysm Trial (ISAT) demonstrated their safety advantages for ruptured aneurysms, they do not always provide the permanent solution that surgical clipping can. The SEATED study, a major UK-wide research project led by King’s College London, is currently tracking outcomes for around 5,000 patients over a decade to address variability in treatment protocols across NHS centres.
Technological innovations are accelerating these possibilities. Robotic microscopes now offer enhanced precision and novel angles of approach, while mixed reality (MR) navigation—which fuses intraoperative X-rays with external images viewed through MR goggles—provides surgeons with a real-time “inside” view of the patient’s anatomy. These tools are pushing the boundaries of what can be achieved through minimal access, though cost and training remain challenges. For Mr Wood, the choice came down to a simple calculation made possible by that engineering precision. The big incisions are gone. The brain was not moved. He went home the next day and returned to building sites a few weeks later. The drawbacks of surgery, in his case, were removed entirely.