06/07/2026
Successful Paediatric Endoscopic Neurosurgery at Kailash Hospital Sector 27 Noida [ Endoscopic Third Ventriculostomy and Cyst Fenestration ] by Neurosurgeon Dr Madhukar T Nayak.
A 6 weeks old baby presented to our Paediatric Neurologist Dr Anshul Dhillon with rapidly increasing size of Head. On Examination the Anterior Fontanelle was tense and bulging. MRI Imaging revealed Bilateral large Frontal Cysts [ ? Porencephalic] compressing on ventricles and causing Obstructive Hydrocephalus.
We successfully performed Endoscopic Intraventricular Cyst Fenestration and Endoscopic Third Ventriculostomy. Thanks to excellent Anaesthesia care, intraoperative phase was smooth and uneventful.
Post Operatively baby was active and alert. Postoperative MRI showed fully collapsed cysts and Hydrocephalus was completely relieved.
Baby had transient Hypothalamic disturbances [ initially Diabetes Insipidus with Hypernatremia and Later SIADH with Hyponatremia] which was efficiently managed by our PICU team. Baby was discharged in a stable condition on Postopday 6.
Endoscopic Third ventriculostomy can be a safe, effective and efficient treatment modality when performed in an advanced Tertiary Care Hospital like Kailash Hospital Sector 27, Noida where we have the experience and expertise for complete Perioperative management of such complex Paediatric Neurosurgery conditions.
Advantages of ETV over traditional VP Shunt :
Because it uses the body's own pathways instead of an artificial implant, ETV offers a highly effective, elegant solution to hydrocephalus, helping patients return to their normal lives sooner.
During an ETV, a neurosurgeon avoids the use of a traditional synthetic shunt by creating a natural bypass thereby avoiding complications associated with Shunts like Shunt infection, blockage, skin erosion in small infants, abdominal Complications etc
More Details about the procedure :
Deep inside our brains, a clear fluid called cerebrospinal fluid continuously cushions and protects the brain tissue, flowing through natural pathways.
Sometimes, these pathways become blocked. This causes fluid to build up, creating painful pressure inside the head—a condition known as obstructive hydrocephalus.
An Endoscopic Third Ventriculostomy, or ETV, is a minimally invasive procedure designed to create a natural bypass for this trapped fluid.
Using a tiny camera called an endoscope, the neurosurgeon safely navigates directly inside the fluid spaces of the brain without disturbing surrounding tissues.
A small, precise opening is made in the floor of the third ventricle. This bypasses the blockage entirely.
The trapped fluid immediately escapes, routing itself into the brain's natural outer pathways where it can be safely reabsorbed. Pressure is relieved.
Because it uses the body's own pathways instead of an artificial implant, ETV offers a highly effective, elegant solution to hydrocephalus, helping patients return to their normal lives sooner.
During an ETV, a neurosurgeon avoids the use of a traditional synthetic shunt by creating a natural bypass.
STEPS OF ETV :
Entry: An endoscope is guided through a small burr hole in the skull into the brain's lateral ventricles.
Navigation: The scope passes through the foramen of Monro into the third ventricle.
Fenestration: A tiny hole (stoma) is made in the floor of the third ventricle
Bypass: This allows trapped cerebrospinal fluid (CSF) to drain into the prepontine cisterns and escape back into the body's normal circulatory pathways.
