What is an endoscopic third ventriculostomy?

An endoscopic third ventriculostomy is a surgical procedure that is commonly done to treat obstructive or non-communicating hydrocephalus in both children and adults. It is a procedure which involves the surgeon creating a bypass for the flow of cerebrospinal fluid in the head, which will then eliminate the need for a ventriculoperitoneal shunt.

Endoscopic means that this procedure is performed with the use of a thin tube that has a light and a camera attached to it, called an endoscope. An endoscope helps guide the surgeon throughout the procedure.

When is an endoscopic third ventriculostomy needed?

An endoscopic third ventriculostomy is normally recommended for people who are diagnosed with a blockage of cerebrospinal fluid in the ventricle system. This condition is called obstructive hydrocephalus. A special MRI imaging technique may be used to diagnose ventricular obstructions that have not been detected. An endoscopic third ventriculostomy may also be recommended for communicating hydrocephalus where there is no visible obstruction in the ventricular system.

What does an endoscopic third ventriculostomy entail?

An endoscopic third ventriculostomy is done under general anaesthesia. The neurosurgeon will shave the hair over the affected area and then clean the area with an antiseptic solution. He will then make an incision on your scalp to give him access to the skull. A hole will be then be drilled in the skull and a flexible endoscope will be inserted through the opening to help guide the neurosurgeon to the location of the cerebrospinal fluid.

An incision will then be made in the brain tissue to allow cerebrospinal fluid to flow out, which will then be absorbed by the body. After the flow of cerebrospinal fluid has been diverted, a titanium cover will be used to patch the hole that was drilled in the skull. The incision will be stitched closed.