Minim Invasive Neurosurg 2010; 53(4): 155-158
DOI: 10.1055/s-0030-1263107
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Water Jet Dissection Technique for Endoscopic Third Ventriculostomy Minimises the Risk of Bleeding and Neurological Complications in Obstructive Hydrocephalus with a Thick and Opaque Third Ventricle Floor

Y. R. Yadav1 , R. Shenoy2 , G. Mukerji3 , V. Parihar1
  • 1Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, India
  • 2Department of Orthopaedics and Neurosciences, Charing Cross Hospital and Imperial College, London, UK
  • 3Department of Urology and Neurosciences, Charing Cross Hospital and Imperial College, London, UK
Further Information

Publication History

Publication Date:
03 December 2010 (online)


Background: Endoscopic third ventriculostomy (ETV) is a procedure of choice in the treatment of obstructive hydrocephalus. Neurovascular injury while perforating the ventricular floor can occur when using a conventional probe, especially in patients with a thick and opaque third ventricle floor. The water jet dissection technique can be useful in such cases to perform an initial perforation.

Patients/Material and Methods: The water jet dissection technique was used to perform ETV in 36 patients with obstructive hydrocephalus with a thick and opaque third ventricle floor over a 3-year period. A water jet was generated using a syringe connected to a 2-mm catheter.

Results: The water jet dissection technique successfully created a patent ETV stoma in 31 patients. 5 patients needed a re-operation due to a blocked stoma. There were no complications related to the procedure. An improvement in clinical function was seen in 28 (83.3%) patients at a median follow-up of 29 months.

Conclusion: The water jet dissection is a useful technique while performing ETV to prevent neurovascular injury. Our improvised technique of creating a water jet is safe, inexpensive, readily available and can be practiced at any centre performing ETV.


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G. MukerjiMD 

Department of Neurosciences

and Urology

Peipheral Neuropathy Unit

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Imperial College

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