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Background: The main criticism of endoscopic excision of colloid cysts of the third ventricle is the decreased ability to completely resect the cyst wall, therefore increasing the risk of recurrence. The extent of resection varies widely across the endoscopic series and is largely influenced by the surgical technique. We report the results of the rotational technique for endoscopic transforaminal excision of colloid cysts in a series of consecutive patients. Our objective is to contribute to the current literature and to shed more light on an effective and safe yet less commonly used technique., Methods: Retrospective analysis was performed on 19 patients. Preoperative magnetic resonance imaging (MRI) was evaluated for cyst characteristics. Postoperative MRI was evaluated for residual cyst membranes. Operative records were reviewed for residual cyst components. Excision grade was determined based on the Barrow Neurological Institute grading scale. Symptom resolution was documented clinically., Results: The study included 13 men and 6 women, with a mean age of 35 years (range, 19-56 years) and mean follow-up of 27.74 months (range, 4-55 months). Total excision was achieved in 17 of 19 cysts (89.5%). A small residual was seen intraoperatively but not radiographically in 1 patient. In another patient, residual cyst membrane seen intraoperatively and radiologically led to recurrence 18 months postoperatively. No mortalities or permanent morbidities occurred., Conclusions: Our high total excision rate and low complication profile are in concordance with the recent reports of endoscopic resection of colloid cysts. The rotational technique for the endoscopic transforaminal approach is highly effective and a safe alternative to the bimanual dissection technique., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Endoscopic excision of colloid cysts is currently well established as a minimally invasive and highly effective technique that is associated with less morbidity in comparison to microsurgical resection., Methods: Operative charts and videos of patients undergoing endoscopic colloid cyst excision were retrieved from the senior author's database of endoscopic procedures and reviewed. This revealed nine trans-foraminal and three trans-septal procedures. Description of the surgical techniques was then formulated., Conclusions: Variation of the technique is based on the specific patho-anatomical features of the colloid cyst being resected. For the trans-foraminal approach, we think that the rotational technique is associated with a more complete removal of the cyst wall and consequently lower recurrence rate.