Development of a novel continuous fluid-filled cadaveric model for full endoscopic intraventricular surgical simulation: anatomic demonstration

Purpose Realistic body donor anatomical simulation of intraventricular neuroendoscopy remains limited because ventricular collapse following cerebrospinal fluid loss prevents preservation of physiological ventricular anatomy. We developed a continuous fluid-filled body donor anatomical model to recreate a realistic intraventricular environment for anatomical research, neuroendoscopic simulation, and surgical training. As a separate but complementary objective, the model was used to demonstrate the feasibility of a novel endoscope-controlled bimanual intraventricular approach transitioning from initial fluid-filled ventricular exploration to dry-field surgery. Methods Five fresh body donor anatomical heads were prepared using a gravity-driven ventricular filling system through a frontal external ventricular catheter. A fully endoscopic transcortical approach was performed using exclusive endoscopic visualization and bimanual microsurgical dissection through a mini-corticectomy. Anatomical exposure, surgical manoeuvrability, and model feasibility were qualitatively assessed. Results Continuous gravity-driven infusion consistently restored and maintained ventricular distension, preserving ventricular anatomy throughout the procedures. Successful ventricular cannulation was achieved in all five specimens, with procedural completion in three. High-quality visualization of the lateral and third ventricles enabled detailed identification of the principal intraventricular landmarks. The proposed approach allowed unrestricted bimanual instrument manipulation through a single surgical corridor under continuous endoscopic visualization and without the need for static retractors. Conclusions The proposed fluid-filled fresh body donor anatomical model provides a realistic and reproducible platform for neuroendoscopic anatomical research, surgical simulation, and training. It preserves ventricular anatomy, enables high-quality endoscopic documentation, and facilitates the evaluation of novel intraventricular techniques. Within this environment, the proposed minimally invasive endoscopic approach proved feasible and reproducible while preserving unrestricted bimanual microsurgical manipulation.