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Aborting a neurosurgical procedure: analyzing the decision factors, with endoscopic third ventriculostomy as a model

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Abstract

Aborting a neurosurgical procedure is a situation in which the surgeon modifies the original surgical plan and decides to stop a procedure without achieving the pre-operative goal. While adhering to predefined goals is important, intra-operative judgment, especially in terms of adjusting the risk/benefit ratio in response to real-time data, may change the balance and lead, in selective scenarios, to aborting of a procedure. The literature regarding aborting a surgical procedure is sparse, with no objective guidelines on when, and how, to make such a decision. Defining “when to abort” is difficult and is influenced by many factors, including unexpected intraoperative findings, the surgeon’s surgical experience and perspective, and the patient and family perspective. Aborting a procedure is a decision that must be ultimately determined by the surgical findings and the individual treatment alternatives. The aim of this paper is to discuss the condition of aborting a neurosurgical procedure, using the relatively common endoscopic third ventriculostomy (ETV) as a model procedure prototype.

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Acknowledgments

We thank Prof. Frederick Boop, MD, and Prof. Leeat Granek, PhD, for their valuable comments and Mrs. Adina Sherer for editorial assistance.

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  1. Department of Pediatric Neurosurgery, Dana Children’s Hospital, Tel-Aviv Medical Center, Tel-Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel

    Jonathan Roth & Shlomi Constantini

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  1. Jonathan Roth
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  2. Shlomi Constantini
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Correspondence to Jonathan Roth.

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Roth, J., Constantini, S. Aborting a neurosurgical procedure: analyzing the decision factors, with endoscopic third ventriculostomy as a model. Childs Nerv Syst 36, 919–924 (2020). https://doi.org/10.1007/s00381-020-04562-1

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