Discovering the novel surgical approach.

Discovering the novel surgical approach requires surgeons to look beyond the dogma of current practices. By applying simple principles and concepts, such as the two-point method, working depth, working area, and angle of attack, novel approaches can evolve from existing approaches to improve exposure and decrease patient morbidity. The EOZ and ELSI are two examples in which these principles have been applied to generate novel surgical approaches by modifying existing ones. Compared to the previously used approaches, both of these novel approaches afford superior access to their respective regions of the brain stem with decreased rates of morbidity.