Septostomy of septum pellucidum – Salvage technique for reversal of ventricular collapse during pure endoscopic surgical resection of third ventricular colloid cyst

Abstract

Colloid cysts are benign cystic lesions. Frequently discovered incidentally, they can be severely debilitating and in rare occasions result in sudden death if not managed appropriately. The surgical options for removal include an open approach, as well as minimally invasive, endoscopic approach. Although associated with decreased morbidity, the endoscopic approach at times must be converted to an open procedure. Finding methods to reduce this conversion can help reduce the associated increase in morbidity.Here we present an endoscopic colloid cyst removal, during which collapse of the ventricle prevented visualization of the working area. A septostomy of the septum pellucidum was done to successfully re-expand the collapsed ventricle and return proper visualization to finish the surgery.Ventricular collapse in pure endoscopic approaches of colloid cyst removal prevents the surgeon from properly visualizing the working area and can frequently result in abortion of the procedure or conversion to open surgery. Because the pure endoscopic approach is associated with less morbidity, it is of benefit to have a salvage technique that prevents conversion to open surgery. Furthermore, fenestration of the septum pellucidum as a salvage technique may be a helpful salvage technique when dealing with ventricular collapse during other pure endoscopic procedures.