General Principles and Intraventricular Neuroendoscopy: Endoscopic Techniques

OBJECTIVE: To term and describe neuroendoscopic techniques. METHODS: A classification into three major groups of endoscopic techniques is presented. RESULTS: 1) Endoscopic neurosurgery ("channel" endoscopy) is mainly used in ventricular endoscopy. The surgical instruments are introduced via working channels that are located within the endoscope. 2) Endoscope-controlled microneurosurgery means that the endoscope is the only visualization tool and microsurgical instruments are used along the endoscope. Major applications are endonasal endoscopic skull base surgery, endoport surgery, and endoscopic transcranial surgery. 3) Endoscope-assisted microneurosurgery means that the microscope and the endoscope are used in the same surgery. The endoscopes are applied when hidden structures to be inspected are not visible in straight line with the microscope. CONCLUSIONS: Endoscopic techniques are a valuable addition to the neurosurgeon's armamentarium. Endoscopes are especially beneficial in deep and narrow surgical approaches and when "looking around a corner" is required.