What Is an Endoscopic Third Ventriculostomy?

Dr. Yongge Xu has focused on the research of neuroendoscopy technology and hydrocephalus for many years. By the end of 2010, he had published more than 20 related papers, more than 10 times were invited to attend and preside over relevant international and domestic academic conferences, and had many external hospital consultations and successfully guided the implementation of neuroendoscopic surgery. The main knife has performed more than 600 cases of various types of neuroendoscopic surgery, and is one of the most experienced neuroendoscopic experts in China. Especially for endoscopic treatment of hydrocephalus, intracranial cysts and pituitary tumors, the technology is mature and effective. In addition, Dr. Xu has nearly 400 cases of complicated hydrocephalus surgery with both experience and lessons. He is one of the most comprehensive, experienced and authoritative hydrocephalus experts in China. "Neuroendoscopy technology" is a prominent representative of the concept of "minimally invasive neurosurgery". The treatment of neurological diseases with "neuroendoscopy technology" has the advantages of less trauma, high safety, fast recovery and low cost. It has been widely used in developed countries, but it has not been widely used in China, and even many large tertiary hospitals cannot carry out this type of treatment. surgery.

Neuroendoscopy

Right!

Neuroendoscopic surgery is divided into two categories according to the endoscopic working environment and operating characteristics:

1. Water environment neuroendoscopic surgery; both cerebrospinal fluid is used as the beam medium, and sheath endoscopy and the associated micro-endoscopic instruments are used for operation; the instruments reach the operation area coaxially with the endoscope through the sheath channel; the operation area is in Intraventricular or cerebrospinal fluid-like cysts. Typical operations are: endoscopic third ventricle ostomy for hydrocephalus and endoscopic cyst-cerebral perforation for intracranial arachnoid cysts.

2. Air-environment neuroendoscopic surgery: both air is used as the beam medium, and observation endoscopes and microneurosurgical instruments or special endoscopic instruments are used for operation; the instruments are separated from the endoscope and reach the angle with a certain freedom outside the scope Operation area; the operation area is on the brain surface or skull base. Typical operations such as: endoscopic intranasal transsphenoidal pituitary tumor resection, endoscopic intracranial hematoma removal, etc.

The following diseases are most suitable for neuroendoscopic treatment:

1. Most hydrocephalus

2. Intracranial arachnoid cyst

3. Transparent septal cyst

4. Intracerebroventricular and paraventricular cysts

5. Most pituitary tumors

6. Hypertensive cerebral hemorrhage

7. Cerebrospinal fluid nasal leak

8. Optic nerve entrapment syndrome

The clinical application of "neuroendoscopy technology" can make many patients with hydrocephalus get rid of the problems of shunt tubes and enjoy a better life with confidence after endoscopic surgery

The clinical application of "neuroendoscopy technology" has made many patients with intracranial cysts avoid craniotomy, which greatly reduces the risk of treatment, reduces the cost of treatment, and has better results!

The clinical application of "neuroendoscopy technology" makes the transsphenoidal pituitary tumor surgery more fine, tumor resection is safer, more thorough, and the effect is better! Our unique navigation and intraoperative MR technology make the endoscope

Transsphenoidal pituitary tumor surgery is more accurate!

The clinical application of "neuroendoscopy technology" makes the hematoma in the brain clear less trauma, and the function recovery is faster and better!

We have more than 1,000 cases of neuroendoscopic surgery experience, and "neuroendoscopic surgery" is our expertise. ^[1]

Advantages of neuroendoscopy for hydrocephalus:

1.It is not easy to cause intracranial or abdominal infections and minimize intraoperative complications;

2, not affected by the growth and development of children, to avoid the pain of multiple tube replacement surgery;

3.The operation is relatively simple, and the time is short compared with traditional surgery;

4. There will be no subarachnoid atresia caused by traditional transcatheter three-ventricular fistula, which may cause surgical failure.

5. Neuroendoscopy has less trauma, good curative effect, fewer postoperative complications, faster recovery, and more in line with human physiological characteristics.

6. Compared with microscope, endoscopic surgery has less trauma, clearer visual field, wider exposure range, can observe lesions at close range, accurate and meticulous operation, greatly reduces surgical injuries, reduces complications, and improves the efficacy of surgery . And the postoperative pain is small, the recovery is fast, the hospital stay is short, and the cost is low.

7. The combination of neuroendoscopy technology and other new technologies, using small incisions, makes some neurosurgical operations more accurate and finer, further reduces the surgical trauma, and even achieves "no snow on the tread".

Compared with surgical microscopes, neuroendoscopic surgery has three advantages:

1. The endoscopic visual tube itself has a lateral viewing angle, which can eliminate the blind area of the visual field during the operation. Neuroendoscopy-assisted microneurosurgery has overcome many visual dead spots in microsurgery, making the surgery more precise and effective. When you reach the lesion, you can get a panoramic field of view, "close-up" the lesion, and enlarge the image to identify the important nerve and blood vessel structures around the side of the lesion and guide the resection of the surrounding lesion tissue. Angled endoscopy shows some pontine cerebellar triangles, basal pools and other corners that cannot be reached by surgical microscopes. In addition, the operation under the direct view of the neuroendoscope can avoid bleeding caused by blind puncture.

2. With the help of stereotactic or neuro-navigation technology, it can be accurately positioned and can handle parts that are difficult to reach with conventional surgery. It is especially suitable for deep or midline lesion surgery. In the deeper field, the brightness of the light source of the operating microscope is attenuated, and the neuroendoscopy is close-range lighting. Although the three-dimensional image of the image is slightly different from the microscope image, the clarity of the deep field is significantly better than that of the surgical microscope.

3 Neuroendoscopy is more suitable for the micro-bone window approach and is less invasive. The diameter of the neuroendoscopy ranges from 0.6 to 6mm, and the damage to the brain tissue is very small. Most neuroendoscopic surgery uses the micro-bone window approach to avoid the trauma to the brain tissue with bone flap craniotomy. The endoscope has a long body and a small cross-section, and is suitable for operation in narrow cavities and channels. These characteristics of neuroendoscopy help to better show the lesions or important structures around the skull, especially for deep lesion operations (such as basal aneurysms) in narrow spaces in microsurgery, which can help reduce the scope of craniotomy Avoid excessive exposure. Surgical microscope; can increase local lighting, softer brightness. ^[2]