New Surgical Therapy for Hydrocephalus: Percutaneous Flexible Endoneurosurgical Choroid Plexus Coagulation

A new flexible fiberoptic ventriculoscope (fiberscope) has been developed for percutaneous endoneurosurgery. This ventriculoscope has a wide channel, of 2.0 mm, allowing the use of a variety of different instruments, including an endoscopic contact Nd-YAG Laser fiber. Using our therapeutic ventriculoscope and contact Nd-YAG Laser fiber, we were successful in carrying out choroid plexus coagulation of the lateral ventricles in an infant with toxoplasmosis. After this procedure, production of cerebro-spinal fluid (CSF) diminished and its protein content gradually decreased. This ventriculoscope was applied safely to a patient in poor condition with hydrocephalus due to intra-ventricular lesions. Percutaneous endoneurosurgical choroid plexus coagulation was useful for this kind of hydrocephalus. This paper describes the device and summarizes its successful use in clinical practice.