62164 Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage

Name of the Procedure:

Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage

Summary

Neuroendoscopy is a minimally invasive surgical technique used to remove brain tumors. The procedure involves the use of an endoscope, a flexible tube with a camera, to navigate through the brain. An external ventricular catheter is also placed to drain cerebrospinal fluid.

Purpose

Neuroendoscopy is performed to remove brain tumors, relieve pressure within the skull, and drain excess cerebrospinal fluid. The expected outcome is the complete or partial removal of the tumor, alleviation of symptoms, and prevention of complications related to increased intracranial pressure.

Indications

• Symptoms such as headaches, vision problems, or neurological deficits caused by brain tumors.
• Hydrocephalus or other conditions causing increased intracranial pressure.
• Patients for whom a less invasive approach is deemed appropriate.

Preparation

• Fasting from midnight before the procedure.
• Discontinuation or adjustment of certain medications.
• Pre-operative imaging studies like MRI or CT scans to plan the surgery.

Procedure Description

1. The patient is administered general anesthesia.
2. A small incision is made in the skull.
3. An endoscope is inserted through the incision to visualize the tumor.
4. Surgical instruments are passed through the endoscope to excise the tumor.
5. An external ventricular catheter is placed to drain cerebrospinal fluid.
6. The incision is closed and the catheter is secured.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity of the tumor.

Setting

The procedure is performed in a hospital operating room, often in a specialized neurosurgical suite.

Personnel

• Neurosurgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding brain tissue
• Cerebrospinal fluid leakage
• Neurological impairments
• Need for further surgery

Benefits

• Minimally invasive with smaller incisions.
• Reduced recovery time compared to traditional open surgery.
• Effective removal or reduction of the tumor.

Recovery

• Monitoring in the intensive care unit (ICU) initially.
• Gradual resumption of normal activities over several weeks.
• Follow-up appointments for imaging and assessment.
• Instructions may include wound care, activity restrictions, and medications to manage pain and prevent infection.

Alternatives

• Open craniotomy: more invasive but allows direct access to the tumor.
• Radiation therapy: non-surgical option often used for inoperable tumors.
• Chemotherapy: used in combination with surgery or as a stand-alone treatment.

Patient Experience

• Patients typically experience grogginess and mild discomfort post-surgery.
• Pain management includes medications and supportive care.
• Full recovery and return to daily activities may take weeks to months, with some temporary or permanent neurological deficits possible.