Operative Nuances of Endoscopic Third Ventriculostomy for Pediatric Obstructive Hydrocephalus

Dewa Putu Wisnu Wardhana , Sri Maliawan

Dewa Putu Wisnu Wardhana
Neurosurgery Department, Medical Faculty, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia.. Email: sri.maliawan@gmail.com

Sri Maliawan
Neurosurgery Department, Medical Faculty, Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia.
Online First: August 05, 2018 | Cite this Article
Wardhana, D., Maliawan, S. 2018. Operative Nuances of Endoscopic Third Ventriculostomy for Pediatric Obstructive Hydrocephalus. Bali Medical Journal 7(2): 351-355. DOI:10.15562/bmj.v%vi%i.904

Background; High incidence of congenital hydrocephalus will become a big problem for the family, and even the nation. The standard management is liquoral shunnting with implantation of various V-p Shunt devices. The complication relatively high beside high cost. Endoscopic third ventriculostomy(ETV) is considered to be superior to V-P Shunt.

Method: All of the Obtructive hydrocephalus admitted to Sanglah Hospital between 2005 until 2016 who treated by ETV were analyzed the method of how we do it.

Result: The most important is patient selection, than  trajectory with rigid endoscope, identify the foramen of Monroe by following choroidal flexus, identify infundibular recess, mammillary body, locate the fenestration of base of the third ventricle safely by monopolar cauther, dilated the fenestration by Fogarty catheter F3/F4, fenestration of Liliquist membrane, and last is closing and suturing the dura and skin water tightly.

Conclusion: ETV is the simple procedure for hydrocephalus lower cost compares to V-p Shunt and high successful rate, and low risk of complication, V-p shunt just for those patients who does not response to ETV.


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