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

Ventricular catheter placement using flexible electromagnetic navigation and a dynamic reference frame

Ventrikelkatheterplatzierung mit der flexiblen elektromagnetischen Navigation und einem dynamischen Referenzrahmen

Meeting Abstract

  • corresponding author T. Rodt - Abteilung Neurochirurgie, Medizinische Hochschule Hannover
  • G. Köppen - Abteilung Neurochirurgie, Medizinische Hochschule Hannover
  • M.J. Mirzayan - Abteilung Neurochirurgie, Medizinische Hochschule Hannover
  • M. Lorenz - Abteilung Neurochirurgie, Medizinische Hochschule Hannover
  • J. Kaminsky - Abteilung Neurochirurgie, Universitätsklinikum Tübingen
  • J.K. Krauss - Abteilung Neurochirurgie, Medizinische Hochschule Hannover

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 03.30

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

Published: May 8, 2006

© 2006 Rodt 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 patients with narrow ventricles catheterisation can proove difficult resulting in misplacement or frustrane trials with the potential consequence of unneccesary damage to brain tissue. Navigational systems are increasingly used in neurosurgery and could be beneficial in these cases. Recently, navigational techniques that do not require fixation of the anatomical structures and techniques for navigated control of flexible instruments have become available.

Methods: The application of a new modul for navigated ventricular catheterisation (AxiEM Ventricular Access) using flexible electromagnetic navigation and a dynamic reference frame is evaluated. A StealthStation AxiEM navigational system was used. CT-data was obtained using multi-slice CT. In four patients suffering from pseudotumor cerebri, meningeosis carcinomatosa and normal pressure hydrocephalus the technique was applied. Evaluation of the accuracy was performed by correlation of the planned target in intraoperative screenshots and postoperative CT.

Results: Navigated catheter placement was accurate and easy to perform in three instances. In one patient it was successful only in the second attempt, since the surgical plan was not followed correctly due to human error. Evaluation of intraoperative screenshots and postoperative CT showed corresponding positions of the catheter tip. The system was easy to handle, although electromagnetic interferences had to be taken into consideration. The time added to the surgical procedure was 30 minutes.

Conclusions: The presented method for navigated catheter placement is helpful in cases with narrow ventricles as it reduces the risk of misplacement or repeated catheterisation trials. The relevance of flexible navigation is subject to further discussion. The use of a dynamic reference frame is helpful, as it allows repositioning of the patient´s head during the procedure.