October 2, 2023

Endoscopic Surgery for Intraventricular Tumors (Podcast)

Presurgical planning and careful consideration of pathology are key to achieving benefits


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Surgical resection is the primary treatment approach for intraventricular tumors, which can be benign or malignant and additionally can affect the flow of cerebrospinal fluid and result in obstructive hydrocephalus. Minimally invasive endoscopic surgery offers several benefits over conventional methods, including reduced risk of complications and faster recovery. However, open surgery remains the best option for some pathologies.

“We don’t move completely from one option to the other; rather, we tend to expand our toolbox,” says Sarel Vorster, MD, MBA, a neurosurgeon in Cleveland Clinic’s Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center. “We see endoscopic surgery not as something that is going to take over brain surgery but as another helpful option. And we find applications that are most suitable.”

In the latest episode of Cleveland Clinic’s Neuro Pathways podcast, Dr. Vorster discusses surgical management of intraventricular tumors and considerations for their endoscopic treatment, including:

  • Diagnosis of intraventricular tumors and other brain lesions
  • The process for deciding between endoscopic and conventional surgery
  • The importance of presurgical planning to ascertain the ideal trajectory through the brain
  • Tools and techniques for endoscopic surgery on intraventricular tumors
  • Technological advancements in the field

Click the podcast player above to listen to the 28-minute episode now, or read on for a short edited excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

This activity has been approved for AMA PRA Category 1 Credit™ and ANCC contact hours. After listening to the podcast, you can claim your credit here.

Excerpt from the podcast

Dr. Vorster: If a tumor enters into a brain ventricle, it’s a whole different approach because we’re dealing with the mass effect of the lesion, or its ability to push on other structures and cause dysfunction as a result. But we’re also dealing with the biology of the tumor, so the degree of resection that’s feasible is a consideration, as is the interaction between the surgical and the oncologic approach to the lesion.

An additional consideration, which is unique to intraventricular tumors, is that the lesion is present in and around the spaces where the spinal fluid is, which raises the prospect that tumor cells could be spread around. It also raises the possibility that fluid could be blocked. For these reasons, surgeons have always been nervous about operating on lesions that go into the ventricles because of the possibility of spreading tumor cells or causing bleeding as the cells enter the fluid.That is still a concern even in contemporary practice — the risk of spreading something that might have been focal previously.


For that reason, we generally do not try to treat malignant tumors endoscopically but rather use an open approach. If a lesion is more on the benign end of the spectrum, it becomes more feasible to take an endoscopic approach. And endoscopic approaches are very appealing, of course, because of their ability, when applied appropriately, to deliver the same quality of outcome with a very small incision.

Related Articles

February 19, 2024
Central Sensitization Syndromes in Pediatric Patients (Podcast)

How functional restoration can help children with these conditions marked by unexplained pain with stigmatized symptoms

February 5, 2024
Diagnosis and Management of Neuromyelitis Optica Spectrum Disorder (Podcast)

Despite advancements, care for this rare autoimmune disease is too complex to go it alone

January 16, 2024
Managing Neurological Disorders in Pregnancy (Podcast)

A discussion of special care considerations before, during and after pregnancy

January 2, 2024
Harnessing the Power of Neuroengineering and AI to Improve Epilepsy Surgery (Podcast)

Data-driven methods may improve seizure localization and refine surgical decision-making

December 15, 2023
Palliative Care for Parkinson’s Disease (Podcast)

When and how a multidisciplinary palliative care clinic can fill unmet needs for this population

December 5, 2023
Diagnosis and Management of Mitochondrial Diseases (Podcast)

Guidance on what should prompt a workup, current and emerging treatment options, and more

November 2, 2023
Neuropsychiatric Challenges Facing Patients With Huntington’s Disease (Podcast)

Behavioral and cognitive symptoms often present early and may go unnoticed

October 17, 2023
A Primer on Pediatric Sleep Disorders (Podcast)

Advice for diagnosing and managing sleep disturbances in children