The Small-Chamber Irrigation Technique (SCIT)

Manwaring, Jotham; Damaty, Ahmed El; Baldauf, Jörg; Schroeder, Henry W. S.

doi:10.1227/neu.0000000000000406

Cited by 13 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another minimally invasive technique for hemorrhage management is the so-called "small-chamber irrigation technique." 12 In short, the endoscope is withdrawn 0.5-1 cm into the endoscope sheath under constant irrigation and placed over the bleeding zone. This creates a small chamber in which the hemorrhage can be stopped by irrigation or coagulation.…”

Section: Discussionmentioning

confidence: 99%

Management of severe intraoperative hemorrhage during intraventricular neuroendoscopic procedures: the dry field technique

Oertel

Linsler

Csokonay

et al. 2019

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVEThe unexpected intraoperative intraventricular hemorrhage is a rare but feared and life-threatening complication in neuroendoscopic procedures because of loss of endoscopic vision. The authors present their experience with the so-called “dry field technique” (DFT) for the management of intraventricular hemorrhages during purely endoscopic procedures. This technique requires the aspiration of the entire intraventricular CSF to achieve clear visualization of the bleeding source.METHODSMore than 500 neuroendoscopic intraventricular procedures were retrospectively analyzed over the last 24 years for documented severe hemorrhages, which were treated by the application of the DFT.RESULTSThe technique was required in 6 cases, including tumor resection/biopsy, cyst resection, and intraventricular lavage. Additionally, the technique was applied as part of the planned strategy in 3 cases of endoscopic tumor removal. The hemorrhage was stopped in all cases and no associated postoperative deficits occurred.CONCLUSIONSAlthough severe hemorrhages are rare, the neurosurgeon needs to be aware of them and has to establish strategies for their management. Most hemorrhages can be stopped by constant irrigation and coagulation. In the other rare cases, the DFT is a safe, reliable technique and can be easily incorporated into endoscopic surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Management of severe intraoperative hemorrhage during intraventricular neuroendoscopic procedures: the dry field technique

Oertel

Linsler

Csokonay

et al. 2019

Journal of Neurosurgery

View full text Add to dashboard Cite

show abstract

“…In endoscopic surgery, vision can be severely restricted even by slight bleeding. Based on our experience and the existing literature, various techniques for hemorrhage control exist, including excessive rinsing, monopolar coagulation, using the heat intensity provided by the light of the endoscope, creating a "fluid chamber" using the trocar or peel-away sheath ("small-chamber irrigation technique"), or using the dry field technique by sucking the CSF out of the ventricles to identify and coagulate the source of bleeding and the air environment also supports the clot formation [19][20][21][22]. These techniques might not suffice for very vascularized lesions compared to microscopic surgery techniques, since forceps for coagulation and adequate suction are not available for neuroendoscopic surgery.…”

Section: Management Of Intraoperative Hemorrhagementioning

confidence: 99%

Endoscopic and Endoscopically-Assisted Resection of Intraventricular Lesions Using a Neuroendoscopic Ultrasonic Aspirator

Ebel

Greuter

Licci

et al. 2021

JCM

View full text Add to dashboard Cite

The development of minimally invasive neuroendoscopy has advanced in recent years. The introduction of the neuroendoscopic ultrasonic aspirator (NUA) broadened the treatment spectrum of neuroendoscopy. We aim to describe our experience with the use of NUA for the resection of intraventricular lesions. Here, we present consecutive retrospective case series of adult and pediatric patients undergoing resection of an intraventricular lesion with a NUA (Endoscopic Neurosurgical Pen, Söring GmbH, Quickborn, Germany) between January 2019 and April 2020. Eight patients between the age of 0.5 and 73 years underwent surgery using NUA and were included in this study. In four patients, an endoscopic assisted (EA) resection of the lesion was undertaken, while in four patients, the lesion was removed using purely endoscopic (PE) resection. In all cases, gross/near total resection was achieved. The average blood loss was 142.5 ± 90.4 mL (range 50–300 mL). Transient morbidity was seen in four patients (50%), while permanent morbidity or mortality did not occur. The NUA seems to be a safe and valuable tool for the minimally invasive resection of intraventricular lesions in selected cases. The type, size, consistency, and vascularization of the lesion limit at times the purely endoscopic use of the NUA.

show abstract

“…To prevent hemorrhagic complications, precisely visualizing the biopsy site and obtaining meticulous hemostasis after the biopsy procedure are essential13). Manwaring et al32) proposed a small-chamber irrigation technique as a simple maneuver for managing intraoperative hemorrhage during endoscopic intraventricular surgery.…”

Section: Tumor Biopsymentioning

confidence: 99%

Transcortical Endoscopic Surgery for Intraventricular Lesions

Kim

2017

J Korean Neurosurg Soc

View full text Add to dashboard Cite

To review recent advances in endoscopic techniques for treating intraventricular lesions via transcortical passage. Articles in PubMed published since 2000 were searched using the keywords ‘endoscopy,’ ‘endoscopic,’ and ‘neuroendoscopic.’ Of these articles, those describing intraventricular lesions were reviewed. Suprasellar arachnoid cysts (SACs) can be treated with ventriculo-cystostomy (VC) or ventriculo-cysto-cisternostomy (VCC). VCC showed better results compared to VC. Procedure type, fenestration size, stent placement, and aqueductal patency may affect SAC prognosis. Colloid cysts can be managed using a transforaminal approach (TA) or a transforaminal-transchoroidal approach (TTA). However, TTA may result in better exposure compared to TA. Intraventricular cysticercosis can be cured with an endoscopic procedure alone, but if pericystic inflammation and/or ependymal reaction are seen, third ventriculostomy may be recommended. Tumor biopsies have yielded successful diagnosis rates of up to 100%, but tumor location, total specimen size, endoscope type, and vigorous coagulation on the tumor surface may affect diagnostic accuracy. An ideal indication for tumor excision is a small tumor with friable consistency and little vascularity. Tumor size, composition, and vascularity may influence a complete resection. SACs and intraventricular cysticercosis can be treated successfully using endoscopic procedures. Endoscopic procedures may represent an alternative to surgical options for colloid cyst removal. Solid tumors can be safely biopsied using endoscopic techniques, but endoscopy for tumor resection still results in considerable challenges.

show abstract

The Small-Chamber Irrigation Technique (SCIT)

Abstract: The SCIT is a powerful tool that the neuroendoscopist can use for visualization to achieve hemostasis when performing intraventricular endoscopic surgery.

Cited by 13 publications

References 16 publications

Management of severe intraoperative hemorrhage during intraventricular neuroendoscopic procedures: the dry field technique

Management of severe intraoperative hemorrhage during intraventricular neuroendoscopic procedures: the dry field technique

Endoscopic and Endoscopically-Assisted Resection of Intraventricular Lesions Using a Neuroendoscopic Ultrasonic Aspirator

Transcortical Endoscopic Surgery for Intraventricular Lesions

Contact Info

Product

Resources

About