Complication avoidance and its management in endoscopic neurosurgery

Endoscopic techniques are increasingly being used in recent times for various spinal and brain pathologies. Although endoscopic neurosurgical technique holds the potential for reducing morbidity, it is also associated with limitations such as steep learning curve, obstruction in manipulation of instruments by telescope in an already limited exposure, proximal blind spot, visual obscuration, disorientation, loss of stereoscopic image and others. Neuroendoscopy is distinct from micro-surgery and a thorough understanding of the technique and its limitations is required to get maximal benefit. Difficulties in controlling bleeding, longer operative time are common obstacles with this technique, especially in early learning curve. Higher complication rate during initial learning curve can be reduced by attending live workshops, practice on models and hands on cadaveric workshops. Large vascular lesions should be avoided and a thorough knowledge of possible complications and techniques to avoid such complications can improve results in endoscopic surgery.