A craniotomy involves an opening into the skull to gain access to different regions of the brain. The standard way to perform this surgery is to make a burr hole with a drill and then cut the bone flap through the bone with a special saw. Usually, more than one burr hole is used.

Intra operative neuro - navigation is frequently used when planning the most appropriate route of access and trajectory.

At the end of the procedure the bone flap is secured in place with fixation devices or small plates and screws.