Three-Dimensional Versus Two-Dimensional Endoscopic Third Ventriculostomy: Surgical Results Of A Preliminary Comparative Study.

BACKGROUND Three-dimensional (3-D) endoscopes have been widely used for a large variety of approaches in neurosurgical practice. However, in the last decade 3-D scopes were barely utilized for ventricular surgery. In the present study, we illustrated our preliminary experience with a 3-D endoscope for third ventriculostomy using a new dedicated endoscopic equipment. METHODS Over a 12-month period, a high definition (HD) 3-D endoscopic third ventriculostomy (ETV) was performed in 14 patients with obstructive hydrocephalus. Patients were followed prospectively and compared retrospectively with a matched group of 16 similar patients who underwent ETV with standard 2-dimensional (2-D) endoscope. Surgical outcome, intraoperative and postoperative course were retrospectively reviewed. RESULTS 3-D ETV provided excellent surgical results and no significative difference was showed in terms of outcome, complication, and length of hospitalization between the two groups. Moreover, operative time was significantly shorter in 3-D than 2-D ETV group (19.9±4.8 vs 22.9±1.4, p<0.05) and the use of the 3-D endoscope provided subjective improvements of depth perception, hand-eye coordination and surgeon's comfort. CONCLUSION Our preliminary study clearly demonstrated the effectiveness of 3-D ETV providing a significant reduction of operative time. Depth information from 3-D scope appears to facilitate rapid and stable ETV maneuvers, representing a critical development that may become a valuable tool for neuroendoscopy.