Video endoscopic neurosurgery (VENS) : a prospective study of 55 patients

Neurosurgery has undergone dramatic innovations in the last few decades. It now allows the use of a microchip camera mounted on to an endoscope, introduced through a key hole in the brain. The image is projected onto a TV monitor located next to theoperating table. The minimally invasive technique is what we call Video Endoscopic Neurosurgery (VENS). Cab's universal rigid endoscope is used in all cases. VENS has a wide spectrum of diagnostic and therapeutic applications but cannot as yet replace open microscopic surgery. A prospective study of 55 patients from January, 1990 to February, 1995 is described. Hydrocephalus was a major indication, where VENS was useful for its diagnostic orientation especially when there were ambiguities on the CT/MRI.It also helped in the proper placement of the shunt, doing a III ventriculostomy and stenting of the aqueduct. VENS was utilised to diagnose, debulk and at times excise III ventricular and various other cystic lesions, visualize vascular loops in trigeminal neuralgia and hemifacial spasm. It is also useful in searching small CP angle lesions and residual tumour after intrassphenoidal excision of pituitary adenoma. Results were satisfactory in 94.5 of patients with an average follow up period of 26.4 months. Laser and CT-guided stereotactic VENS have already arrived which allows precise target localization and excellent visual control of any bleeding.