Water jet dissection technique for endoscopic third ventriculostomy minimises the risk of bleeding and neurological complications in obstructive hydrocephalus with a thick and opaque third ventricle floor.
{"title":"Water jet dissection technique for endoscopic third ventriculostomy minimises the risk of bleeding and neurological complications in obstructive hydrocephalus with a thick and opaque third ventricle floor.","authors":"Y R Yadav, R Shenoy, G Mukerji, V Parihar","doi":"10.1055/s-0030-1263107","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Endoscopic third ventriculostomy (ETV) is a procedure of choice in the treatment of obstructive hydrocephalus. Neurovascular injury while perforating the ventricular floor can occur when using a conventional probe, especially in patients with a thick and opaque third ventricle floor. The water jet dissection technique can be useful in such cases to perform an initial perforation.</p><p><strong>Patients/material and methods: </strong>The water jet dissection technique was used to perform ETV in 36 patients with obstructive hydrocephalus with a thick and opaque third ventricle floor over a 3-year period. A water jet was generated using a syringe connected to a 2-mm catheter.</p><p><strong>Results: </strong>The water jet dissection technique successfully created a patent ETV stoma in 31 patients. 5 patients needed a re-operation due to a blocked stoma. There were no complications related to the procedure. An improvement in clinical function was seen in 28 (83.3%) patients at a median follow-up of 29 months.</p><p><strong>Conclusion: </strong>The water jet dissection is a useful technique while performing ETV to prevent neurovascular injury. Our improvised technique of creating a water jet is safe, inexpensive, readily available and can be practiced at any centre performing ETV.</p>","PeriodicalId":49808,"journal":{"name":"Minimally Invasive Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2010-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0030-1263107","citationCount":"21","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minimally Invasive Neurosurgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0030-1263107","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2010/12/3 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 21
Abstract
Background: Endoscopic third ventriculostomy (ETV) is a procedure of choice in the treatment of obstructive hydrocephalus. Neurovascular injury while perforating the ventricular floor can occur when using a conventional probe, especially in patients with a thick and opaque third ventricle floor. The water jet dissection technique can be useful in such cases to perform an initial perforation.
Patients/material and methods: The water jet dissection technique was used to perform ETV in 36 patients with obstructive hydrocephalus with a thick and opaque third ventricle floor over a 3-year period. A water jet was generated using a syringe connected to a 2-mm catheter.
Results: The water jet dissection technique successfully created a patent ETV stoma in 31 patients. 5 patients needed a re-operation due to a blocked stoma. There were no complications related to the procedure. An improvement in clinical function was seen in 28 (83.3%) patients at a median follow-up of 29 months.
Conclusion: The water jet dissection is a useful technique while performing ETV to prevent neurovascular injury. Our improvised technique of creating a water jet is safe, inexpensive, readily available and can be practiced at any centre performing ETV.