Background: Ventriculo-peritoneal shunt is the definitive treatment for hydrocephalus. In the last two decades endoscopic procedures for obstructive hydrocephalus replaced the traditional shunt systems. Technical improvements of endoscopic instruments have provided new modes of treatment that are less invasive and less traumatic for the patient.
Objective: We describe our experience with different transventricular endoscopic procedures over a three years period (2011-2013) in our institution.
Material and Methods: We retrospectively reviewed the charts of patients who underwent transventricular endoscopic procedure in a three years period between January 2011 to December 2013 at the pediatric neurosurgery unit- Hadassah medical center. We looked for the indications, demographic characteristics, complications and failure rate.
Results: Thirty four consecutive children (mean age: 23 months, range: 0-120) underwent endoscopic procedure. We performed 21 ETVs, 4 septum pellucidotomies, 4 cyst fenestration, 2 pineal region tumor biopsy and 2 tumor resection were performed. ..The indication for septum pellucidotomies was lateral ventricle entrapment. Two patients with cystic craniopharyngiomas
underwent endoscopic drainage of the cyst and insertion of an intracystic catheter connected to an Ommaya reservoir. The overall complication rate was 15% which included seizures, wound infection, CSF leak and meningitis. Four children failed the endoscopic procedure and eventually a V-P shunt was inserted.
Conclusion: Endoscopic third ventriculostomy is a safe and effective treatment for obstructive hydrocephalus. Transventricular endoscopic procedures are safe approaches with low rates of complication, permanent morbidity, and mortality.
