Abstract

Endoscopic evacuation of intracerebral hemorrhage has seen significant advances in surgical instruments and techniques. The advantage is a less invasive surgery for a short operation time compared with craniotomy surgery. On the other hand, the main disadvantage is uncertain hemostasis and the potential for postoperative bleeding. To overcome this problem, we employ a unique surgical maneuver involving an endoscopic diving technique that switches between a dry and wet field. This technique, which expands the hematoma cavity by maintaining irrigation by artificial CSF, results in easy identification of small bleeding points and securing hemostasis by observing actively bleeding vessels in a clear visual field. Endoscopic hematoma removal has been positioned as an advanced hematoma removal method using keyhole surgery. Endoscopic diving technique with switching between a wet and dry field can provide safe and effective surgery. Although more experience is needed to determine whether this technique improves surgical outcomes, the preliminary results are more promising than craniotomy surgery.

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