gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Waterjet dissection – a new tool for endoscopic neurosurgery?

Wasserstrahldissektion – Eine neue Technik für die Endoskopie?

Meeting Abstract

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  • corresponding author J. Oertel - Department of Neurosurgery, Hannover Nordstadt Hospital
  • M. Gen - Department of Neurosurgery, Hannover Nordstadt Hospital
  • M.R. Gaab - Department of Neurosurgery, Hannover Nordstadt Hospital

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 01.6

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Oertel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: In neurosurgery, waterjet application for tissue dissection and vessel preservation is increasing. However, a peculiar advantage of the device could be its application in minimally invasive procedures such as neuroendoscopy when vessel preservation is of particular importance such as in endoscopic ventriculostomy or septostomy.

Methods: A new waterjet hand piece was developed for endoscopic applications. The handpiece consists of a 120µm nozzle emitting a helically turned waterjet. At first, the device was tested in 10 cadaveric porcine brains. Subsequently, the device was applied in 3 endoscopic procedures.

Results: In the pig brain, a precise and accurate septostomy was achieved in all cases under endoscopic conditions. After septostomy, enlargement of the stomy was performed without any difficulties with a forgarty balloon catheter. Clinically, the device was applied in 2 cases of hydrocephalus due to intraventricular hemorrhage and blockage of the aqueduct and in 1 cystic craniopharyngioma case with blockage of both foramen of Monroe. In all three cases, the view could be cleared with waterjet irrigation and suction. In addition, the cyst wall of the craniopharyngioma as well as the floor of the third ventricle could be perforated accurately with the waterjet at 8 bar. No complications were noted.

Conclusions: Based on these very limited results, the waterjet application appears to be safe in endoscopic procedures. A reliable stomy could be achieved with pressures under which vessels are preserved. Thus, with the waterjet device, the risk of vessel injury could possibly be further minimized. However, further studies are needed before definite conclusion can be drawn.