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Related Experiment Video

Updated: Dec 20, 2025

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy

Published on: June 28, 2024

Frame-Based Stereotactic Endoscopic Third Ventriculostomy-Toward Improved Precision and Minimizing Morbidities.

Clark C Chen¹, David Freeman¹, Peter C Warnke²

¹Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota.

World Neurosurgery

|May 22, 2020

Summary

Endoscopic third ventriculostomy (ETV) for hydrocephalus can be made safer. Navigation guidance precisely identifies optimal entry points, reducing surgical complications by minimizing endoscope manipulation.

Keywords:

ETV Endoscopy Frame-based stereotaxis Safety Stereotactic

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Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection

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Published on: August 15, 2025

Area of Science:

Neurosurgery
Medical Imaging
Anatomy

Background:

Endoscopic third ventriculostomy (ETV) is a standard treatment for obstructive hydrocephalus.
Current ETV procedures often lack navigation guidance, leading to complication rates between 1% and 8%.
A discrepancy between external bony landmarks and internal cranial anatomy may contribute to ETV-related morbidities.

Purpose of the Study:

To investigate the hypothesis that anatomical discrepancies contribute to ETV complications.
To compare the traditional Kocher's point entry with the ideal entry point determined by frame-based stereotaxis.

Main Methods:

3D reconstructions were created from CT scans of 58 patients who underwent stereotactic ETV.
The actual entry point (Kocher's point) was compared to the ideal entry point for optimal trajectory.

Main Results:

>70% of ideal burr hole trajectories were at least 0.5 cm from Kocher's point in both sagittal and coronal planes.
Significant median deviations were observed: 0.74 cm coronal (P < 0.01) and 0.81 cm sagittal (P < 0.0001).

Conclusions:

Stereotactic navigation enhances the safety of ETV by improving precision.
Utilizing stereotactic endoscopic techniques reduces unnecessary surgical maneuvers, thereby increasing patient safety.