Three-dimensional high-definition ventriculoscope: a single centre case-series.

BACKGROUND: Three-dimensional (3D), high-definition (HD) endoscopy has been recently introduced in neurosurgery and its value extensively discussed in endonasal skull base surgery. There is no reported clinical series on the use of a recent 3D-HD ventriculoscope.

OBJECTIVE: Aim of this study is to describe our initial experience with this novel device.

METHODS: Patients consecutively operated on from June 2016 to June 2018 with a 3D-HD ventriculoscope were prospectively collected. The system is a 6 mm, 0° optic with a 105° field of view, with a central working channel of 2.2-mm diameter and two side channels of 1.3 mm diameter. Patients' demographic data, pre-operative symptoms and neurological status, neuroradiological data, type of surgery, operative time, intra- and post-operative complications, follow-up data were prospectively recorded and retrospectively reviewed.

RESULTS: 24 patients (age range: 3-84 years) underwent 25 procedures, including endoscopic third ventriculocisternostomy (ETV), biopsy and cyst fenestration. The technical goal of surgery was obtained in all patients. There were no intraoperative complications, expect for one intraoperative epileptic seizure. Post-operative complications included asymptomatic subdural collections in two patients, infection and delayed ETV closure in one patient each. Relative limits of the system are its size and the availability of only a 0° optic. Image quality appeared satisfactory in all procedures. The lack of a dedicated introducer was resolved exploiting a vascular "peel-away" system.

CONCLUSION: 3D-HD technology seems to provide potential advantages also in ventricular surgery. This initial experience is promising, but has to be confirmed by larger series.