Brain Endoscopy

An endoscope is a device that allows a surgeon to operate through a limited opening by providing remote visualization, illumination, and manipulation. The typical endoscope used in neurosurgery features a lens and camera for visualization, a light source for illumination, and one or more channels through which instruments can be directed for surgical manipulation. Most of the current applications of endoscopy in neurosurgery are directed at hydrocephalus.

While an endoscope can be helpful to the neurosurgeon in many ways, most neurosurgical procedures cannot be performed solely through an endoscope for a variety of reasons. The endoscope is most helpful when used to open a membrane, place a catheter at a precise location, or biopsy lesions associated with the brain’s fluid chambers (ventricles).

Endoscopic Cyst Fenestrations

Other thin membranes and cyst walls within or around the brain can be opened using the endoscope to relieve pressure caused by the blockage of CSF circulation. The technique is similar to an ETV but the hole is made to release an isolated (trapped) pocket of CSF into a ventricle or the subarachnoid space. Sometimes a small tube (stent) is left to keep the hole open after it is made.

Endoscope-Assisted Shunt Insertion

Endoscopes small enough to fit inside shunt tubes are sometimes used to achieve the best possible placement of the catheter tip within the patient’s ventricle. This technique can be applied to both new shunt insertion and the revision of shunts whose ventricular catheters are blocked.

Endoscopic Tumor Surgery

Brain tumors located within or adjacent to the lateral or third ventricles can often be reached with an endoscope. Only the smallest tumors can be removed through the endoscope and complete removal remains unlikely. A more reasonable goal in these situations is tumor biopsy. Many tumors that occur in these areas are either impossible to cure by any surgical treatment or can be cured with non-surgical means making complete removal unnecessary. As tumors in these locations frequently cause obstructive hydrocephalus, the biopsy can be combined with a simultaneous fenestration procedure.

Meet Our Physicians

Elad I. Levy

MD MBA FACS FAHA, Chairman

Clinical Team

Neuroendovascular & Stroke

Office Location(s)

40 George Karl Blvd, Suite 100 Williamsville, NY 14221

716.218.1000

Gregory J. Castiglia

MD FACS

Clinical Team

Spine & Skull Base Disorders

Office Location(s)

40 George Karl Blvd, Suite 100 Williamsville, NY 14221

716.218.1000

Jason M. Davies

MD PhD

Clinical Team

Minimally Invasive Brain Endoscopy

Neuroendovascular & Stroke

Office Location(s)

1001 Main St. 4th Floor Buffalo, NY 14203

40 George Karl Blvd, Suite 100 Williamsville, NY 14221

716.218.1000

John G. Fahrbach, IV

MD

Clinical Team

Spine & Skull Base Disorders

Office Location(s)

40 George Karl Blvd, Suite 100 Williamsville, NY 14221

716.218.1000

WNY Locations

  • General Physicians, PC

  • John R. Oishei Children’s Hospital

  • Erie County Medical Center

  • Buffalo General Medical Center

  • Roswell Park Comprehensive Cancer Center

  • Gates Vascular Institute

  • Summit Park Office Complex

  • Oishei Children’s Outpatient Center

  • Brook Bridge Medical Complex

  • Conventus Building

  • Comprehensive Neuroscience Center

Surgical Locations:  Sisters of Charity Hospital, Niagara Falls Memorial Medical Center, Millard Fillmore Suburban Hospital, Mercy Hospital of Buffalo, Buffalo General Medical Center, Gates Vascular Institute, Kenmore Mercy Hospital

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Publications | August 14, 2020

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The Professional and Personal Impact of the Coronavirus Pandemic on US Neurointerventional Practices: A Nationwide Survey

In the News | January 23, 2017

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Dr. Davies awarded the UB CTSA KL2 grant

The KL2 Research Career Development Program supports state-of-the-art clinical and translational research and provides young investigators with the knowledge and skills necessary to perform high-impact research and succeed in today’s highly competitive research environment.  

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