Suction Catheter as an Endoscopic Port for Simultaneous Real-Time Neuronavigation and Neuroendoscopy: A Technical Note.

The combined use of neuronavigation and neuroendoscopy enhances safety and accuracy during intraventricular procedures, particularly in pediatric patients with complex ventricular anatomy such as multiseptate hydrocephalus. However, conventional endoscopic sheaths and integrated systems often limit the simultaneous use of navigation, visualization, and endoscopic instruments. We describe a simple, cost-effective technical modification using a standard 14 Fr green suction catheter (approximately 4.7 mm internal diameter and 20 cm length) repurposed as a working conduit to allow simultaneous passage of a rigid neuroendoscope along with either a navigation wand or an interventional instrument such as a Fogarty catheter or monopolar cautery. The technique was successfully applied in an 8-month-old infant with congenital multiseptate hydrocephalus undergoing navigation-guided endoscopic septal fenestration. The modified conduit enabled uninterrupted real-time navigation and visualization, provided adequate working space for intervention, and eliminated the need for repeated instrument exchanges without intraoperative complications. A routinely available suction catheter can serve as an effective dual-channel endoscopic port, allowing simultaneous neuronavigation, neuroendoscopic visualization, and intraventricular intervention without additional cost.