VIA GRAPHIC PLUS | BATANGAS, Philippines – For many Filipinos facing serious neurological conditions, the challenge is not only finding the right treatment, but finding a neurosurgeon and a hospital equipped with the specialized technology and expertise needed for it.
A 2024 study on the Philippine neurosurgical workforce found that only 174 neurosurgeons were practicing in the country. That’s approximately one neurosurgeon for every 600,000 Filipinos. Thirty-five provinces have no neurosurgeons at all, leaving an estimated 24 million people underserved. The study also estimated that nearly 93,500 cases requiring essential neurosurgery occur in the Philippines every year.
As of 2026, the latest tally provided by the Academy of Filipino Neurosurgeons places the number of practicing neurosurgeons in the country at an estimated 185. This reflects the continued growth of the neurosurgical workforce, while also highlighting the persistent need to improve access to specialized care across the country.
The gap is particularly significant because neurosurgical diseases can have devastating consequences when diagnosis or treatment is delayed. Cerebrovascular diseases, including stroke, accounted for 68,729 deaths in the Philippines in 2024, making them the country’s third-leading cause of death at 9.8 percent of all registered deaths, according to the Philippine Statistics Authority.
Against this backdrop, Mary Mediatrix Medical Center is taking a step toward bringing more advanced neurosurgical care closer to patients in Batangas.
The hospital has successfully performed its first minimally invasive neuroendoscopic procedure for an adult patient with hydrocephalus, marking what Mediatrix identifies as the first such procedure performed by a private hospital in Batangas province.
The milestone expands the range of sophisticated neurosurgical procedures that can now be performed at the Batangas-based tertiary hospital, potentially reducing the need for patients to travel outside the province to seek specialized brain surgery.
Potentially fatal pressure
The patient, a middle-aged female, was diagnosed with hydrocephalus after imaging revealed a tumor in the third ventricle of the brain that was obstructing the normal flow of cerebrospinal fluid.
Hydrocephalus occurs when cerebrospinal fluid accumulates in the brain, increasing pressure within the skull. If left untreated, the pressure can become life-threatening, potentially compressing the brainstem and affecting consciousness, breathing and heart rate.
Neurosurgeon Dr. Asis Jr. Encarnacion, who performed the procedure, said the case demonstrated how minimally invasive technology can allow surgeons to safely access difficult-to-reach areas of the brain.
“Neuroendoscopy allows us to see structures deep inside the brain through a much smaller surgical pathway. 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. For a lesion located in such a critical area, that can make a significant difference in how we approach the patient.”
Diagnostic imaging, including CT scans and MRI, showed that the patient had a non-malignant craniopharyngioma. Because of the tumor’s deep and critical location, the surgical team determined that attempting complete removal could cause greater injury to the brain. Instead, the team performed an endoscopic biopsy to establish the diagnosis while addressing the hydrocephalus.
An endoscopically assisted ventriculoperitoneal (VP) shunt with septostomy was subsequently performed to restore the drainage of cerebrospinal fluid.
Compared with conventional approaches requiring a larger opening to access the brain, neuroendoscopy uses a small access pathway and a specialized endoscope equipped with a camera and surgical instruments. The technique allows the neurosurgeon to visualize the target area directly while performing procedures through a minimally invasive approach.
Advanced care closer to home
For Mary Mediatrix, the procedure represents more than a single surgical milestone. It is part of the hospital’s continuing effort to expand the sophistication and accessibility of neurosurgical care in the province.
Mary Mediatrix has maintained a neurosurgical service since the 1990s. In recent years, the hospital has invested in advanced technology and training to strengthen its neurosurgical capabilities, including a neurosurgical microscope and other equipment needed for endoscopic procedures.
The development is significant in a country where access to neurosurgical care remains highly uneven. The Philippine neurosurgical workforce study found that one in five Filipinos did not have access to a full-time neurosurgeon and emphasized that geographic distribution is as important as the overall number of specialists.
For patients with brain tumors, hydrocephalus, stroke and other conditions requiring neurosurgical intervention, access is a crucial aspect for a patient’s recovery and survival. “In neurosurgery, having the specialist is only one part of the equation,” said Encarnacion. “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.”
The first neuroendoscopic procedure at Mary Mediatrix is also a reflection of the hospital’s broader investment in developing its neurosurgical service. Its residency program provides trainees with exposure to neurosurgical procedures as part of their broader surgical training, while the hospital’s continuing investment in advanced equipment helps expand the capabilities available to both specialists and patients.
Closing the access gap
The need for stronger neurological healthcare capacity is increasingly recognized in the Philippines. A study by researchers from the University of the Philippines Manila’s Department of Neurosciences noted that neurological disorders represent a major public-health challenge globally, particularly in low- and middle-income countries, while comprehensive data on the prevalence of neurological diseases in the Philippines remain lacking.
This lack of data makes the country’s neurosurgical workforce findings even more significant: the problem is not simply the number of patients who need brain and nervous-system care, but whether the health system has enough specialists, facilities and technology to reach them in time.
For Encarnacion, the goal ultimately goes beyond being the first. “The real significance of this milestone is not that we performed the first procedure. 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.”
Mediatrix’s latest milestone is one step toward addressing that gap in Batangas. By building the expertise and infrastructure needed to perform minimally invasive neurosurgical procedures locally, the hospital aims to make advanced brain care more accessible to patients in the province while continuing to develop its capacity to manage increasingly complex neurological conditions.
Started in 1927, the Philippines Graphic is the longest-running printed magazine of national circulation that provides relevant news and features and promotes Philippine literature.
