Special Clinical Focus

  • Microsurgery procedures for tumours of the brain, of the base of the skull and of the spinal cord
  • Microvascular neurosurgery for aneurysms, cavernomata and malformations (vascular malformation) with intraoperative angiography
  • Minimally invasive surgery for intervertebral disc prolapse and constricted spinal canal
  • Trauma to the brain and skull with cranial reconstruction
  • Microscopic and endoscopic surgery on the pituitary gland (hypophysis) and base of the skull
  • Endoscopic procedures for dysfunctions of the cerebral spinal fluid circulation and tumours / cysts in the region of the ventricular system

About us

Dr Ralf Kockro is a specialist neurosurgeon at the Hirslanden Hospital, Zurich. The Neurosurgery Department of the Hirslanden Hospital is equipped to the highest technical standard and the most complicated surgery is performed on the brain, spinal cord and the spine. The Hirslanden Neurosurgery Department is the only hospital department in Switzerland where an intraoperative MRI, CT and an angiography unit are available and this enables tissue-conserving and, at the same time, safe and effective surgery to be performed. Minimally invasive procedures are the focus of our neurosurgery and, in this context, detailed preparation and surgical planning with the aid of high-definition and three-dimensionally reconstructed MRI and CT data are of particular importance because these enable the performance of individually tailored, and hence very precise, surgical approaches.

In all phases of patient care, the Neurosurgery Department of the Hirslanden Hospital is embedded in a close interdisciplinary collaboration, which, over and above the actual surgical procedure, guarantees the highest specialist standard of treatment for each condition.

Dr Kockro specialises, in particular, in the field of microneurosurgery for brain tumours and tumours of the spinal column and adjacent structures. He heads the development of a navigation system, which provides the surgeon with essential information during surgery about the optimum surgical approach using a 3-D image overlay, and he is involved in several studies in the field of intraoperative MRI, fluorescence and ultrasound. Particularly for malignant tumours, the MRI information obtained during the surgery, together with continuous electrophysiological signals (neuromonitoring), produces a crucial benefit for patient safety and, at the same time, a high success rate for the complete excision of tumours. In the field of pituitary surgery (pituitary adenomata), Dr Kockro performs endoscope-guided surgery and in open MRI in order to achieve the optimum excision of the tumour. Of course, in performing surgery via the nose, he acts in concert with ORL specialists.

A further focus of Dr Kockro’s work is in the field of vascular neurosurgery. He has developed an online calculator for assessing the risk of any verified aneurysms (www.kockro.com) and works in close interdisciplinary collaboration with his colleagues in the Neuroradiology Department in order to be able to provide, individually in each case, the best treatment possible for the closure of an aneurysm. Arterio-venous malformations (AVMs) and fistulae are also analysed across disciplines and the best strategy for the conclusive closure is prepared. If there is surgery on an aneurysm or an AVM, the individual anatomical situation is portrayed in high-definition in a virtual simulator, unique in Switzerland, the development of which Dr Kockro has headed for more than 10 years. Based on this 3-D simulation, the procedure is performed with the highest possible level of effectiveness and the least possible risk. Microvascular decompressions, such as for trigeminal neuralgia or hemifacial spasm, are also precisely simulated and planned prior to the procedure and hence are performed precisely and gently.

Of course, endoscopic techniques are also used for almost all vascular surgery and for surgery on the base of the skull. Thereby, the surgical site can be accurately illuminated and inspected and, even in areas which are difficult to view, thanks to the angled lines of sight, gentle surgery can be successfully performed without blind manipulation.

The focus of the spinal surgery of Dr Kockro is minimally invasive microsurgery. This ranges from dilating the narrowed spinal canal by means of locally limited and precisely planned perforation of the vertebral arch, which maintains stability, through intervertebral disc surgery and to artificial discs in the region of the cervical spine (prosthetic intervertebral disc).

In the field of hydrocephalus, Dr Kockro has worked in close collaboration with one of the leading hospitals in this field worldwide, the University of Heidelberg, for some years. Dr Kockro has wide experience, both in terms of the evaluation and of the treatment of the various forms of hydrocephalus, which also includes, in particular, endoscopic techniques for restoring the CSF flow.

Dr Kockro is a specialist consultant for all major neurosurgical scientific journals and he is the lead author of a large number of frequently cited scientific publications and chapters of textbooks. He holds three international patents in the field of computer-guarded neurosurgery.

You can go to the website of Dr Kockro here.

Diagnostic Services

  • Minimally invasive surgery planning on the 3-D simulator and surgery in open MRI and CT
  • High-resolution MRI / CT / PET imaging for precise surgical planning, in particular, functional MRI for depicting the motor centres and the speech centre.
  • Three-dimensional surgery planning on the virtual simulator (Dextroscope II) for preoperative simulation of the most suitable minimally invasive approach and for planning a suitable surgical strategy.
  • Complete specialist neurological diagnostics (MEP, SEP, AEP, NLG, VEP, EEG, Sleep Laboratory)
  • Diagnosis of epileptic lesions using electrode implantation
  • Diagnosis of normal pressure hydrocephalus by means of continual CSF drainage and neuropsychological assessment.

Therapeutic Services

  • The most up to date minimally invasive technologies in microscope- and endoscope-guided tumour surgery (e.g. glioma, astrocytoma, glioblastoma, meningeoma, neurinoma, ependymoma, metastases) with intraoperative imaging: intraoperative (open) MRI and CT, as well as intraoperative high-definition ultrasound.
  • Microscopic integrated fluorescence imaging of tumours using 5-ALA.
  • Vascular neurosurgery (aneurysm, AVM, angioma, dural fistula), controlled by intraoperative angiography, microdoppler and ICG angiography
  • Electrophysiological intraoperative neuromonitoring (MEP, SEP and cortical / subcortical mapping)
  • Surgery while conscious, in particular for procedures on the centres of the brain controlling speech and movement.
  • 2-D / 3-D neuronavigation including 3-D fibre tracking and fMRI
  • Endoscope-assisted microvascular decompression for trigeminal neuralgia and hemifacial spasm
  • Endoscope- and MRI-guided procedures on pituitary tumours (adenomata)
  • Endoscopic procedures in the ventricular system for hydrocephalus, tumours and cysts
  • VP shunt procedures (abdominal, endoscopic) for hydrocephalus
  • Epilepsy surgery including amygdalo-hippocampectomy with electrophysiological monitoring and intraoperative EEG
  • Injuries to the cranium and brain (traumatic brain injury) including the excision of haemorrhages, plastic closure, closure of CSF fistulae and cranial reconstruction with tailor-made plastic implants
  • Paediatric neurosurgery for tumours, malformations and hydrocephalus
  • Minimally invasive spinal surgery: microsurgical and endoscope-guided disc surgery and tailor-made minimally invasive surgery for narrowing of the spinal canal (spinal canal stenosis). Intervertebral disc replacement using cages or prostheses.
  • The most up to date microsurgery for tumours of the spinal cord and tumours of the spinal canal (astrocytomata, ependymomata, neurinomata, meningeomata, pilocytic astrocytomata), including ultrasound and permanent electrophysiological monitoring.

Special Offers / Arrangements / Rooms

  • Modern single and 2-bed rooms with flat-screen TV and WLAN, many with a balcony and a view of Lake Zurich.
  • First-class, prestigious hotels of Hirslanden Hospital
  • Support for international patients by the Hirslanden International Bureau: co-ordination and organisation of consultations, medical reports, cost estimation, hotel reservations, admission to rehabilitation clinics, health spa stays, as well as transport and travel advice
  • 24-hr interpreter service
  • On-site underground parking
Leading Medicine Guide

of selected experts in the specialist field Neurosurgery

Other services

  • Aneurysm
  • Cerebral tumours: glioblastoma, astrocytoma, meningeoma
  • Pituitary adenoma
  • Trigeminal neuralgia
  • Spinal canal stenosis, intervertebral disc prolapse
  • Traumatic brain injury

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