What it is
Neuroendoscopy uses a rigid or flexible endoscope — a small camera with a working channel for instruments — to operate inside the fluid-filled spaces of the brain (the ventricles) through a single small burr hole. No brain retraction is required. The surgeon navigates by watching a camera feed rather than through a microscope, and instruments passed through the working channel perform the procedure.
Common neuroendoscopic procedures
Endoscopic third ventriculostomy (ETV): The most common neuroendoscopic procedure. A small opening in the floor of the third ventricle creates a new CSF drainage pathway for obstructive hydrocephalus. (See separate ETV page.)
Colloid cyst removal: Colloid cysts are benign lesions that form at the roof of the third ventricle and can obstruct CSF flow, causing intermittent or acute hydrocephalus — and in rare cases, sudden death from acute obstruction. Endoscopic removal through a small frontal burr hole is the preferred approach at experienced centers, avoiding open craniotomy.
Intraventricular tumor biopsy/resection: Tumors growing within the ventricles — ependymomas, choroid plexus papillomas, subependymal giant cell astrocytomas — can be biopsied or partially resected endoscopically, reducing the need for open craniotomy.
Septum pellucidotomy: Creating an opening between compartmentalized ventricular cavities to normalize CSF flow.
Advantages over open approaches
The core advantage of neuroendoscopy is access through a much smaller corridor, with direct visualization inside the ventricular system, and no brain retraction. For the procedures it is suited to, it represents a meaningful reduction in surgical morbidity compared to open craniotomy approaches.