Neuroendoscopic Procedures and Applications

The operative interventions in which neuroen-doscopy can play a definitive or supportive role can be classified by site and disease into: those within the internal cerebrospinal fluid spaces -principally the cerebral ventricles, those within the brain parenchyma, and those outside the brain in the subarachnoid or subdural spaces or extracranial skull base (Table 6.3).

Although most neuroendoscopic operations are minimally invasive, they should not be regarded as "minor procedures". They should only be undertaken in fully staffed and equipped neurosurgical operating rooms by surgeons who are prepared to proceed to an open operation if necessary. Nursing and resident medical staff must be available for postoperative observation and supervision as for any other intracranial neurosurgical operation. The operations most commonly undertaken relate to the management of hydrocephalus.

Table 6.3. Neuroendoscopic indications and procedures

Anatomical site

Condition

Treatment

Intraventricular

Hydrocephalus

Primary treatment NTV

Shunt insertion Aqueductaplasty Choroid plexectomy Shunt complications NTV

Shunt liberation Marsupialization Shunt removal

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