Techniques of endoscopic third ventriculostomy.

Modem techniques of endoscopic third ventriculostomy (ETV) are based on the concept of establishing a natural conduit for cerebral spinal fluid (CSF) flow through the floor of the third ventricle. Through the years, a wide variety of techniques have been used as a means to this end and have included both open and closed approaches. However, the relatively recent application of endoscopic technology to intraventricular surgery has allowed neurosurgeons to perform third ventriculostomies in a minimally invasive fashion. Advances in third ventriculostomy technique have been based on a detailed understanding of third ventricular anatomy, surgical trajectories, and improved instrumentation. The goal of this article is to discuss these issues in detail and to point out the relevant risks and known complications associated with them.