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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Shuntoscope-guided versus free hand technique in ventricular catheter placement

Shuntoskopie-gesteuerte versus freie-Hand-Technik bei der Anlage des intraventrikulären Katheters

Meeting Abstract

  • Mohammed Nofal - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland
  • presenting/speaker Mohammed Issa - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland
  • Andreas W. Unterberg - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland
  • Ahmed El Damaty - Universitätsklinikum Heidelberg, Neurochirurgie, Heidelberg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV196

doi: 10.3205/21dgnc191, urn:nbn:de:0183-21dgnc1915

Published: June 4, 2021

© 2021 Nofal et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: The position of the intraventricular catheter is essential for a proper function of the cerebral shunt system or external ventricular drainage. Placement of the catheter usually depends on the skills of the surgeon using Free-Hand-Technique and can lead to position-dependent complications. However, a camera-assisted method using the semi-rigid shuntoscope can be helpful. Shuntoscope-assisted ventricular catheter placement has been reported to reduce shunt failure in uncontrolled series. We investigated the efficacy of both techniques in a retrospective monocentral study.

Methods: Between September 2018 and August 2020, in 55 pediatric and adult procedures an intra-ventricular catheter with two different techniques were implanted; the shuntoscope-guided technique (n=29) and the free-hand technique (n=26). The records were reviewed retrospectively. Catheter positioning was graded on postoperative imaging using three-point scale from Hayhurst et al. [1]. All patients were operated by the same surgeon. Complications and revisions rate were compared between the two groups.

Results: 29 patients, 6.3 years old in average, range 1.4 – 27.7 years, 48.3% female and 51.7% male, received intra-ventricular catheter using the shuntoscope-guided technique. 26 patients, 28.6 years old in average, range 1.0 – 79.5 years, 73.1% female and 26.9% male, received intra-ventricular catheter using the free-hand technique. The success rate for the optimal placement of the intra-ventricular catheter with a grade I on the Hayhurst scale was significantly higher in the shuntoscope group (93.1%) than in the free-hand group (80.2%), p <0.029. 20.7% of the patients in the shuntoscope group had a revision operation, one revision was due to wound infection, on the contrary, the revision rate was in the Free-Hand-Group higher with 31.8%.

Conclusion: Our current study confirms that insertion of the intra-ventricular catheter using shuntoscope-guided technique in pediatric and adult patients is a safe and effective procedure with high success rate of a correct position and fewer related complications and revisions.


References

1.
Hayhurst C, Beems T, Jenkinson MD, Byrne P, Clark S, Kandasamy J, Goodden J, Nandoe Tewarie RD, Mallucci CL. Effect of electromagnetic-navigated shunt placement on failure rates: a prospective multicenter study. J Neurosurg. 2010 Dec;113(6):1273-8. DOI: 10.3171/2010.3.JNS091237 External link