ENDOSCOPIC THIRD VENTRICULOSTOMY (ETV)
Endoscopic third ventriculostomy is a surgical procedure used to treat hydrocephalus and may eliminate the need for a ventriculoperitoneal shunt, which is an implant used to divert cerebrospinal fluid (CSF). Endoscopic third ventriculostomy (ETV) provides patients with a long-lasting surgical option.
Endoscopic indicates that surgery is conducted using an endoscope. An endoscope is a thin tube with a solid light source, a powerful magnification lens. The endoscope can be used with a tubular system that has an opening through which miniature instruments are inserted. The third ventriculostomy is the region of the brain where the fluid bypass is created. Since a common site of blockage is the narrow passage between the third and fourth ventricles of the brain, the bypass is created through the thin membrane at the base of the third ventricle. It is then possible for cerebrospinal fluid to flow from the lateral ventricle of the brain to the third ventricle of the brain and from the third ventricle to the regular fluid chambers beneath the brain base. The cerebrospinal fluid then flows upward and across the brain's surface, where it is reabsorbed into the bloodstream.
WHEN IS ENDOSCOPIC THIRD VENTRICULOSTOMY NECESSARY?
An endoscopic third ventriculostomy is a procedure done to treat hydrocephalus. Hydrocephalus may arise for many different reasons; however, when there is an obstruction to the flow of CSF at the cerebral aqueduct, in conditions such as brain tumours or aqueductal stenosis, an ETV is the procedure of choice.
HOW IS THIS SURGERY DONE?
This procedure aims to create a hole in the floor of the third ventricle to allow CSF to drain from the brain. Prior to surgery, MRI scans are used to diagnose the condition and assess whether an ETV will be suitable.
During an endoscopic third ventriculostomy, Dr Profyris will use an endoscope fitted with a camera to perform the surgery. The operation is performed through a tiny incision and hole in the skull. The endoscope is inserted into the brain's water system and directed toward the third ventricle. An opening is made in a thin membrane at the floor of the third ventricle and will relieve the obstruction by allowing CSF to flow below the base of the brain, over the surface of the brain, where it can be reabsorbed by the body.
The most important aspect of any brain surgery is safety. In general however the procedure takes less than an hour.
Recovery is variable among patients. Hospital stays are usually less than a few days and recovery is in general fairly quick
Although ETV is generally a very basic neurosurgery procedure, any brain operation can be dangerous. Our aim is to make every surgery as safe as humanly possible through meticulous pre-operative planning, application of keyhole techniques, obsessive attention to operative technique and application of multiple technologies. Dr Profyris will have a detailed discussion in relation to the procedure and potential risks.