Laser-assisted endoscopic third ventriculostomy for obstructive hydrocephalus: technique and results in a series of 40 consecutive cases.
OBJECTIVE
To report a case series of endoscopic third ventriculostomy (ETV) using laser in 40 consecutive patients with obstructive hydrocephalus.


METHODS
Under stereotactic and endoscopic guidance, multiple perforations in the ventricular floor using a 1.32 microm neodymium-yttrium/aluminum/garnet (Nd-YAG) or a 0.805 microm diode laser unit and removal of intervening coagulated tissue ensued with a 4-6 mm opening between third ventricle and basilar cisterns.


RESULTS
The procedure could be completed in all cases. A transient complication occurred in five cases. In 39 patients (mean follow-up 28 months), 31 (79%) had a favorable outcome. Failure occurred in six patients, requiring permanent shunting leading to complete recovery, and two patients remained in a poor clinical status despite ETV.


CONCLUSIONS
Laser-assisted ETV is a safe and efficient procedure for the treatment of obstructive hydrocephalus. Laser is advantageous in cases of distorted anatomy and may reduce technical failures.
Devaux
Bertrand C
BC
Department of Neurosurgery, Centre Hospitalier Sainte-Anne, rue Cabanis, 75674, Paris cedex 14, France. devaux@chsa.broca.inserm.fr
Joly
Luc-Marie
LM
Page
Philippe
P
Nataf
François
F
Turak
Baris
B
Beuvon
Frederic
F
Trystram
Denis
D
Roux
François-Xavier
FX
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods*