Article
Shuntoscope-guided versus free hand technique in ventricular catheter placement
Shuntoskopie-gesteuerte versus freie-Hand-Technik bei der Anlage des intraventrikulären Katheters
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Published: | June 4, 2021 |
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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