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Endoscopic Third Ventriculostomy and Pineal Biopsy from a Single Entry Point
Published on: June 28, 2024
Laser-assisted endoscopic third ventriculostomy for obstructive hydrocephalus: technique and results in a series of
Bertrand C Devaux1, Luc-Marie Joly, Philippe Page
1Department of Neurosurgery, Centre Hospitalier Sainte-Anne, rue Cabanis, 75674, Paris cedex 14, France. devaux@chsa.broca.inserm.fr
Background And Objectives:
To report a case series of endoscopic third ventriculostomy (ETV) using laser in 40 consecutive patients with obstructive hydrocephalus.
Study Design/Materials And Methods:
Under stereotactic and endoscopic guidance, multiple perforations in the ventricular floor using a 1.32 microm neodymium-yttrium/aluminum/garnet (Nd-YAG) or a 0.805 microm diode laser unit and removal of intervening coagulated tissue ensued with a 4-6 mm opening between third ventricle and basilar cisterns.
Results:
The procedure could be completed in all cases. A transient complication occurred in five cases. In 39 patients (mean follow-up 28 months), 31 (79%) had a favorable outcome. Failure occurred in six patients, requiring permanent shunting leading to complete recovery, and two patients remained in a poor clinical status despite ETV.
Conclusions:
Laser-assisted ETV is a safe and efficient procedure for the treatment of obstructive hydrocephalus. Laser is advantageous in cases of distorted anatomy and may reduce technical failures.
