Endoscopic Third Ventriculostomy (ETV) for Hydrocephalus

What is an Endoscopic Third Ventriculostomy (ETV)?

Endoscopic third ventriculostomy (ETV), is a less invasive surgery used to reroute a surplus of cerebrospinal fluid (CSF) due to hydrocephalus, a condition that results in the accumulation of CSF in the brain’s ventricles. A tiny perforation is created within the floor of the third ventricle, enabling the smooth flow of CSF from the obstructed ventricular system within the healthy CSF space (interpeduncular cistern).

The ETV procedure is considered a successful surgical alternative to a shunt when treating an obstruction that severely impacts the flow of cerebrospinal fluid. Unlike shunt surgery, ETV does not involve the placement of a foreign body in the body, reducing the risk of infection and the need for periodic shunt revisions.

How do you perform an Endoscopic Third Ventriculostomy (ETV)?

An endoscope, a tiny lighted scope with a camera attached, is passed through a small hole in the skull and directed towards the floor of the third ventricle. The advanced, illuminated optic system enables the surgeon to operate with utmost precision and care within the ventricles of the brain. A balloon Is used to create a small hole in the floor of the third ventricle. As a result, cerebrospinal fluid can travel smoothly from the brain's third ventricle to the new entrance, eventually flowing to the normal fluid chambers underneath the base of the brain.

What can you expect following an Endoscopic Third Ventriculostomy (ETV)?

After the procedure, the patient will be transferred to the recovery unit. Usually, the patient will be required to remain overnight in the hospital over the next few days, where he or she is carefully monitored. For example, medical staff will ensure the patient eats and consumes fluids well and adequately manages their pain with prescription pain medication. The patient will also be monitored for any signs of complications, such as infection, leakage of fluid from the wound or excessive bleeding.

A follow-up consultation is crucial since the operative site is closely monitored, and imaging scans (MRI and CT scans) are ordered to assess the patients health, response to the medical procedure, and whether the hole made during the procedure is still open. This follow-up care is important to ensure the long-term success of the ETV procedure and to address any potential issues that may arise.