Endoscopes are increasingly being used for transcranial endoscopic procedures. These endoscopes are only 2.7mm in diameter. They can be used to perform various conditions through a single burr hole. Thus, this is one of the most minimally invasive methods to treat brain disorders. Most of these pathologies are intraventricular and deep seated. Conventional microscopic methods require significant dissection and retraction of the normal brain parenchyma to reach this region. Endoscopes through a passage along a tract through the brain minimise this access related morbidity.
Various conditions that can be treated using transcranial endoscopy include:
1. Endoscopic third ventriculostomy--
this is the most basic and most commonly performed procedure. This is used for treating hydrocephalus by making internal diversion when obstruction to the CSF exists. The benefit include avoiding the need for a shunt -- a foreign body that makes the patient shunt dependant for ever in addition to the risk of shunt malfunction and repeat surgery.
2. Endoscopic biopsy --
tumors adjacent to the ventricular wall such as thalamic, posterior third ventricular tumors bulge into the ventricle causing obstructive hydrocephalus. Using endoscopy, one can safely achieve two goals simultaneously -- treating hydrocephalus and taking biopsy from the bulging portion of the tumor.
3. Tumor excision --
intraventricular lesions as colloid cysts, cysticercal cysts cause dilatation of the ventricles and can be removed using endoscopes.