How is endoscopic third ventriculostomy performed?

An ETV is performed by fenestrating the floor of the third ventricle, thus creating a passage between the third ventricle and the prepontine cisterns. Hydrocephalus is commonly treated with cerebrospinal fluid (CSF) diversion with shunt placement.

How long does a endoscopic third ventriculostomy take?

The procedure is performed under general anaesthesia and generally takes around 60 minutes.

How much does endoscopic third ventriculostomy cost?

The average costs per patient in the group treated with ETV was USD$ 2,177,66±517.73 compared to USD$ 2,890.68±2,835.02 for the VPS group.

How is ETV surgery performed?

In this procedure, surgeons use a tiny camera called an endoscope to enter the ventricles in the brain. They then make a small opening in one of the ventricles, which relieves the pressure buildup by allowing fluid to flow again. The procedure is called an ETV, or “endoscopic third ventriculostomy.”

How successful is ETV surgery?

In terms of ETV in tumoral hydrocephalus; in a study of thirty pediatric patients developing hydrocephalus amongst 104 who underwent posterior fossa surgery, ETV was found to have a success rate of more than 90% and has been recommended as the ideal treatment for hydrocephalus in such cases51).

Is endoscopic third ventriculostomy safe?

Although endoscopic third ventriculostomy (ETV) is a safe procedure, a variety of complications have been reported, mostly related with the surgical procedure. The overall morbidity rate reported is 8.5%, ranging from 0 to 31.2%, and the overall rate of permanent morbidity is 2.38%6,7,19,25).

Is endoscopic third Ventriculostomy safe?

Is ETV better than shunt?

There are several benefits of an ETV versus a ventriculoperitoneal shunt. Compared to a shunt, there are no implanted foreign bodies, fewer incisions and an overall lower long term complication rate. This means there is less discomfort, a lower infection rate, and less time in the hospital.

Is ETV safe?

Conclusions: ETV is a safe procedure with excellent rates of long-term efficacy; however, late failure can occur, and patients should be instructed to seek medical advice if symptoms recur. A previous shunt is associated with a higher ETV failure rate.

How long does a third ventriculostomy last?

Results: The study population comprised 190 patients, with a median age of 43 years (range, 16-79 years). The median duration of follow-up was 112 months (range, 1-190 months). The primary ETV group contained 129 patients; the secondary ETV group, 61 patients. Operative complications occurred in 11 patients (6%).

Who is a candidate for endoscopic third ventriculostomy?

Age greater than 6 months with aqueduct stenosis or tectal tumor and no previous shunting can be considered as an ideal candidate for ETV. ETV works best as a primary procedure in obstructive hydrocephalus without evidence of prior infection or hemorrhage (Fig. 1).

Who is a candidate for endoscopic third Ventriculostomy?

How successful is ETV?

How long does a third Ventriculostomy last?

What is an endoscopic third ventriculostomy?

Endoscopic third ventriculostomy (ETV) is a minimally invasive procedure indicated for the treatment of hydrocephalus. An ETV is performed by fenestrating the floor of the third ventricle, thus creating a passage between the third ventricle and the prepontine cisterns.

How has the success rate of third ventriculostomy improved?

An improvement in the success of third ventriculostomy in recent time could be due to better patient selection; improvements in endoscope, better imaging, advanced surgical technique and instruments. Endoscopic third ventriculostomy is increasingly used in the treatment of hydrocephalus.

What is the role of intra-operative ventriculo-stomography in the evaluation of endoscopic tracheostomy (ETV)?

Intra-operative ventriculo-stomography could help in confirming the adequacy of endoscopic procedure, thereby facilitating the need for shunt. Intraoperative observations of the patent aqueduct and prepontine cistern scarring are predictors of the risk of ETV failure. Such patients may be considered for shunt surgery.

What is the role of ultrasonic probe in the workup of third ventriculostomy?

An ultrasonic contact probe (NECUP-2) can be used to create minimal and controlled lesion in third ventriculostomy.[64] If any hemorrhaging is encountered during the procedure, copious warm fluid irrigation should be used until all bleeding is visibly stopped and the ventricular CSF is clear.