Typical case “Finally, no more intubation and shunt! We as parents don’t have to worry about it for the rest of our lives!” These were the first words spoken by Zhong’s father, a strong man who tried to restrain his feelings, but could not hide his excitement and joy. Zhong, one of the twin premature babies, had hydrocephalus after hemorrhage and ventricular infection after external ventricular drainage at a local hospital. He received electronic neuroendoscopic ventricular lavage and third ventricular floor fistula at the Neurology Center of the Aviation General Hospital of China Medical University, and the child was able to breastfeed two hours after surgery, and his behavioral response returned to normal with remarkable results, and he is expected to be discharged from the hospital six days after surgery. Etiology, symptoms and treatment of hydrocephalus Hydrocephalus is a general term for an excessive amount of cerebrospinal fluid and an increase in pressure due to an impairment in the process of cerebrospinal fluid production or circulation and absorption, which expands the space occupied by normal cerebrospinal fluid, resulting in a secondary increase in cranial pressure and ventricular enlargement. Congenital malformations, intracranial infections or hemorrhages, intracranial tumors or other occupying lesions can lead to this disease. The global incidence of hydrocephalus is 8 per 10,000, and the annual number of new patients with hydrocephalus in China is 360,000, of which about 40% are pediatric patients. The main cause of hydrocephalus in children (also called “pediatric hydrocephalus”) is a congenital factor, but also the sequelae of meningitis. The main symptoms of hydrocephalus in children are irritability, developmental delay, headache and vomiting, lethargy, epilepsy, etc. Signs include increased head circumference, high fontanelle tone, difficulty in upward vision, optic papilloma, and abducens nerve palsy, etc. Symptoms vary with the age of onset of the child. Currently, cerebrospinal fluid shunt surgery for hydrocephalus has been widely adopted by the neurosurgery department of municipal hospitals and above in China because of its ease of operation, but it is not a solution for the treatment of hydrocephalus. Because cerebrospinal fluid itself has nutritive, supportive and protective effects on the brain and spinal cord, diverting cerebrospinal fluid through a shunt to the abdominal cavity, thoracic cavity, veins or atria increases the burden on these parts for no reason, and also weakens the nutritive supportive and protective effects of cerebrospinal fluid on the nervous system. In addition, there are many complications of cerebrospinal fluid shunt surgery. In addition to lifelong dependence on the shunt, shunt obstruction, infection, and displacement require repeated shunt adjustments, which increase patients’ pain and impose a great mental and economic burden on patients and their families. With the continuous improvement and perfection of neuroendoscopic equipment and surgical instruments, the surgery is becoming less and less traumatic and more and more effective, and is gradually accepted and recognized by the medical community and patients at home and abroad. It is gradually becoming the first choice for hydrocephalus treatment. The indications for the new technology Clinically, hydrocephalus is usually divided into two categories: traffic hydrocephalus and non-traffic hydrocephalus according to the neuroimaging examination. For hydrocephalus with clear obstruction on neuroimaging, neuroendoscopic ventriculostomy can restore the normal circulation of cerebrospinal fluid by unblocking the obstruction. In this case, endoscopic third ventricle-pool fistula can also improve cerebrospinal fluid circulation and alleviate the development of hydrocephalus to some extent. In general, the indications for endoscopic third ventriculostomy include the following four categories: 1) obstructive hydrocephalus caused by non-occupying lesions should be the preferred surgical approach; 2) obstructive hydrocephalus caused by tumors in the brainstem, the base of the third ventricle, and the vicinity of the aqueduct; 3) traffic hydrocephalus with significant enlargement of the third ventricle; 4) cases in which lateral ventriculo-peritoneal shunts have failed or are not suitable for shunt surgery. In cases of hydrocephalus, endoscopic third ventriculostomy may have unexpected results. Endoscopic third ventriculostomy is more effective than other procedures in treating hydrocephalus caused by stenosis of the conduit or benign occupying lesions in the posterior cranial fossa, with an efficiency of more than 85%, respectively. Especially for pediatric hydrocephalus patients, as the child grows up, multiple abdominal shunts are required, which are prone to complications and are more dangerous, whereas endoscopic third ventriculostomy is much more effective in this regard and is currently the most ideal choice for the treatment of pediatric obstructive hydrocephalus. In the treatment of hydrocephalus with neuroendoscopy, a flexible electronic endoscope has a significant advantage over a rigid endoscope. A flexible electronic endoscope, like the specialized tools used to unclog a sewer, allows for greater exploration and unblocking of the cerebrospinal fluid circulation pathways, achieving better results with less surgical trauma.