[Pediatric Neuroendoscopic Surgery]

Pediatric neuroendoscopic surgery involves a wide range of indications and surgical techniques. Neuroendoscopy has become an essential tool in the management of hydrocephalus in children. Given the heterogeneity of clinical presentations, surgical strategies must be individualized for each case. Additionally, the procedures must consider the fragility of the pediatric brain and emphasize minimally invasive approaches. Such surgeries often involve a high proportion of intraventricular manipulation under continuous irrigation, requiring the appropriate selection of endoscopes and specialized devices suited for such environments. Furthermore, compared with adults, pediatric patients are more prone to complications, including infection, cerebrospinal fluid leakage, and subdural hematoma, necessitating meticulous management during intraoperative cerebrospinal fluid irrigation and wound closure. In this study, we describe the characteristics and key considerations of pediatric neuroendoscopic surgery based on our experience with endoscopic third ventriculostomy (ETV) for noncommunicating hydrocephalus, fenestration of arachnoid cysts, and combined procedures using flexible scopes and rigid ventriculoscopes.