Mary Mediatrix Medical Center has successfully performed its first minimally invasive neuroendoscopic procedure on an adult patient with hydrocephalus, marking what the hospital said was the first procedure of its kind performed by a private hospital in Batangas.
The milestone expands the range of specialized neurosurgical procedures available in the province and could reduce the need for patients with complex neurological conditions to travel to Metro Manila or other areas for treatment.
The development comes as the Philippines continues to face a shortage and uneven distribution of neurosurgeons. A 2024 study on the country’s neurosurgical workforce found only 174 practicing neurosurgeons, or roughly one for every 600,000 Filipinos.
The study found that 35 provinces had no neurosurgeons, leaving an estimated 24 million Filipinos underserved. It also estimated that nearly 93,500 cases requiring essential neurosurgery occur in the country each year.
As of 2026, the Academy of Filipino Neurosurgeons estimates that the number of practicing neurosurgeons has increased to about 185, reflecting gradual growth in the workforce but also underscoring the continuing challenge of making specialized care accessible outside major urban centers.
The shortage is particularly significant because delays in treating neurological conditions can have serious or fatal consequences. Cerebrovascular diseases, including stroke, accounted for 68,729 deaths in the Philippines in 2024, representing 9.8% of registered deaths and making them the country’s third-leading cause of death, according to the Philippine Statistics Authority.
Minimally Invasive Procedure
The patient at Mary Mediatrix, a middle-aged woman, was diagnosed with hydrocephalus after imaging revealed a tumor in the brain’s third ventricle that was blocking the normal flow of cerebrospinal fluid.
Hydrocephalus occurs when cerebrospinal fluid accumulates in the brain, increasing pressure inside the skull. Without treatment, the pressure can become life-threatening and potentially affect consciousness, breathing and heart function.
Neurosurgeon Dr. Asis Jr. Encarnacion, who performed the procedure, said neuroendoscopy allows surgeons to reach difficult areas of the brain through a considerably smaller surgical pathway.
“Neuroendoscopy allows us to see structures deep inside the brain through a much smaller surgical pathway,” Encarnacion said. “In this case, we were able to directly visualize the tumor and obtain a biopsy while minimizing the amount of normal brain tissue that had to be disturbed.”
CT scans and MRI identified the tumor as a non-malignant craniopharyngioma. Because of its deep and critical location, the surgical team determined that attempting to completely remove the tumor carried a greater risk of damaging surrounding brain structures.
Instead, the team performed an endoscopic biopsy to establish the diagnosis while addressing the patient’s hydrocephalus. An endoscopically assisted ventriculoperitoneal, or VP, shunt with septostomy was subsequently performed to restore the drainage of cerebrospinal fluid.
Unlike conventional approaches that may require a larger opening to access the brain, neuroendoscopy uses a small surgical pathway and a specialized endoscope equipped with a camera and instruments. This allows surgeons to directly visualize and operate on targeted structures through a minimally invasive approach.
Expanding Neurosurgical Care in Batangas
Mary Mediatrix has maintained a neurosurgical service since the 1990s and has invested in equipment and training in recent years to expand its capabilities, including a neurosurgical microscope and equipment required for endoscopic procedures.
The expansion is significant given the geographic disparities in neurosurgical care in the Philippines. The 2024 workforce study found that about one in five Filipinos did not have access to a full-time neurosurgeon, emphasizing that the distribution of specialists is as important as their overall number.
For patients with brain tumors, hydrocephalus, stroke and other neurological conditions requiring surgery, proximity to appropriately equipped hospitals can affect how quickly they receive treatment.
“In neurosurgery, having the specialist is only one part of the equation,” Encarnacion said. “You also need the hospital infrastructure, the technology, the instruments, the trained support team and the ability to manage the patient before, during and after surgery.”
“Developing all of these capabilities in Batangas means that more patients can have access to specialized neurosurgical care without having to leave the province,” he added.
The hospital also maintains a residency program that provides trainees exposure to neurosurgical procedures as part of their broader surgical training, alongside continuing investments in specialized equipment.
Closing the Access Gap
The need to strengthen neurological healthcare capacity has become increasingly important as the country’s population grows and demand for specialized treatment rises.
Researchers from the University of the Philippines Manila’s Department of Neurosciences have described neurological disorders as a major public-health challenge, particularly in low- and middle-income countries, while noting that comprehensive data on the prevalence of neurological diseases in the Philippines remain limited.
The country’s neurosurgical workforce figures consequently highlight a broader challenge: ensuring that patients not only have access to specialists, but also to hospitals with the technology, infrastructure and trained personnel needed to provide advanced neurological care.
For Encarnacion, the significance of the Batangas procedure lies less in being the first than in establishing a capability that can be used for future patients.
“The real significance of this milestone is not that we performed the first procedure,” he said. “It is that we are building the capability to offer patients in Batangas more options for the treatment of serious neurological conditions. Every time we add a new capability, we close the access gap between a patient and the specialized care they need.”
With the successful procedure, Mary Mediatrix is expanding its ability to manage complex neurological cases locally, providing patients in Batangas with greater access to minimally invasive neurosurgical treatment closer to home.