• Y R Yadav, R Shenoy, G Mukerji, and V Parihar.
• Department of Neurosurgery, NSCB Medical College and Hospital, Jabalpur, India.
• Minim Invasive Neurosurg. 2010 Aug 1; 53 (4): 155-8.

BackgroundEndoscopic 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 MethodsThe 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.ResultsThe 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.ConclusionThe 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.© Georg Thieme Verlag KG Stuttgart · New York.

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