• 6-year-old girl
• Unwell, lethargic, vomiting
• MR scan: hydrocephalus, large infiltrating tumour in left hemisphere extending to left lateral and third ventricle with ventriculomegaly due to third ventricular obstruction
• Endoscopic biopsy of the third ventricular component through the right lateral ventricle

EQUIPMENT USED

• Aesculap Minop endoscope
• 30o optical lens
• Blunt biopsy forceps
• Neuronavigation

SURGICAL TIPS

• Approach from the side of the larger ventricle, to have more room for maneuvering and adequate working space
• Choose for biopsy site an area with lesser chance of bleeding
• Avoid coagulation at biopsy site, to avoid misdiagnosis on the specimen
• Twist forceps during biopsy to avoid bleeding (spaghetti technique)