Endoscopic adjuncts to intraventricular surgery.

Recently, endoscopic intraventricular surgery has been performed successfully in several clinical series. Although the therapeutic results must be compared with conventional surgery, neuroendoscopy seems to be a safe surgical technique when performed by surgeons with appropriate experience and refined endoscopic tools. Rigid or flexible endoscopes equipped with various-sized working channels should be selected depending on the nature of the pathologic findings. The well-proven tenets of microsurgery must not be sacrificed for the sake of more rapid surgical time and noninvasiveness; thus, endoscopic surgery must adhere to the principles of microsurgery. The improved visualization and lower morbidity have established neuroendoscopy in the management of specific disease processes, such as obstructive hydrocephalus. Its further use in the management of intraventricular cysts and tumors is dependent on long-term follow-up and the development of even better instrumentation.