What are the indications for neuroendoscopy

  Neuroendoscopic techniques are mainly used to treat the following cranio-cerebral diseases: 1. Hydrocephalus: ventriculo-abdominal shunt for hydrocephalus is recognized as the operation with the highest neurosurgical failure rate, with a 1-year surgical failure rate of about 40%. Postoperative shunt obstruction (including obstruction at the ventricular end, shunt valve obstruction and obstruction at the abdominal end), insufficient shunt, excessive shunt, and ventricular system infection mostly occur, especially for pediatric patients, with Especially for pediatric patients, as they grow older, the shunt system needs to be constantly adjusted or replaced, which brings huge psychological and economic burdens to patients and families. Our neurosurgery department is the first to use neuroendoscopy to treat hydrocephalus, especially for obstructive hydrocephalus, by adopting ventriculoscopic triple ventriculostomy, which directly drains the over-secreted cerebrospinal fluid into the subarachnoid space, in accordance with the human cerebrospinal fluid circulation mechanism, without any pressure difference in the ventricular system, and without placing a ventriculo-abdominal shunt, completely avoiding a series of complications such as shunt obstruction, rupture, infection, and encapsulation. This can completely avoid a series of complications such as shunt obstruction, rupture, infection and encapsulation, and greatly reduce hospitalization time and cost; and for hydrocephalus requiring shunt placement, neuroendoscopic and laparoscopic surveillance can be used to place the end of the shunt in the ventricle and the safe and reliable location of the abdominal cavity, which greatly reduces postoperative complications such as ventricular end obstruction and abdominal end encapsulation, not only alleviating the patient’s pain, but also reducing the economic burden of the family. 2. Intracranial arachnoid cyst: Previously The treatment of intracranial arachnoid cysts mostly requires craniotomy, which results in heavy postoperative reactions, long hospital stays and high costs. Ventricular system tumor is still a difficult problem in domestic treatment, because it is prone to hydrocephalus, intraventricular blood accumulation, ventricular system infection and other serious complications after surgery. The use of ventriculoscopic intracerebroventricular tumor biopsy or resection can take tumor and cerebrospinal fluid specimens under the direct view of ventriculoscope, which makes the pathological diagnosis of tumor more reliable and provides an objective and accurate basis for the next treatment plan, while ensuring the cerebrospinal fluid circulation pathway and effectively avoiding the occurrence of postoperative hydrocephalus; some tumors can be completely resected, effectively avoiding the huge risk brought by craniotomy.4. Skull base occupations. Especially for pituitary tumor and Lark’s cyst in the saddle area, the pterygoid point approach, anterior longitudinal fissure approach and inferior frontal approach are mostly used in the past, which require long time pulling on the brain tissue during tumor resection and are prone to serious complications such as late intracranial blood, brain tissue swelling and optic nerve damage after surgery, and the surgical risk is large. The neuroendoscopic approach through the nasopalatine sinus does not require craniotomy, no surgical incision on the head, little damage to normal tissues, little surgical risk, fast postoperative recovery, and can be discharged in about 1 week. 5. Cerebral hemorrhage: especially for patients with ventricular system hemorrhage and ventricular cast, intraoperative blood accumulation in the brain can be removed under neuroendoscopic surveillance, timely restoration of cerebrospinal fluid circulation pathway, and relief of cranial hypertension, which largely reduces The rate of disability and death of patients with cerebral hemorrhage is largely reduced.