Laser Navigation Combined With XperCT Technology Assisted Puncture of Brainstem Hemorrhage

Abstract

BackgroundBrainstem hemorrhage has a rapid onset with high mortality and disability rates. In recent years, an increasing number of studies have reported on the surgical treatment of brainstem hemorrhage. The introduction of stereotaxic instruments and navigation systems has improved the accuracy of surgical treatment; however, the popularity of these devices in the primary hospitals is not high. In this study, we introduce laser navigation combined with the XperCT technology to assist in the puncture and drainage of brainstem hemorrhage, aiming to improve surgical accuracy and facilitate the drainage of brainstem hemorrhage in primary hospitals.Material and MethodsA total of five patients (four men and one woman), aged 34–70 years, who underwent hematoma puncture drainage with the assistance of laser navigation combined with XperCT technology at the Binzhou Medical University Hospital, China, between June 2020 and Aug 2021 were included in the study. The brainstem hemorrhages had volumes of 7–18 ml. Statistical analyses of the postoperative puncture deviation distance (distance between the actual puncture end and simulated puncture end) and postoperative improvement were also performed.ResultsThe operations were successfully completed in all five patients. The puncture deviation distance was <6 mm in all five patients and <2 mm in two patients. The postoperative hematoma clearance rate was about 70%−90%. Among four patients with respiratory failure, three had improved breathing and resumed spontaneous breathing. Out of three patients with high fever, one showed a substantial decrease in body temperature. There were no cases of postoperative infection. Of the five patients, two recovered consciousness, one died, and two voluntarily gave up further treatment and were discharged.ConclusionsLaser navigation combined with the XperCT technology could improve the accuracy of surgical puncture. The technique might be convenient for widespread clinical application because of its low trauma, high precision, short operation time, and low operation cost.

Neuroendoscopy-Assisted Entire-Process Visualization Technique of Ventricular Puncture for External Ventricular Drainage

“…In addition, the presence of the laser equipment over the surgical field interferes somewhat with the operation, which can introduce a certain degree of puncture error. 23,24 Among the patients in the laser-assisted group in our study, there were 2 cases of suboptimal drainage tube positioning. We attributed this to positional drift resulting from a slight deviation in the angle of view during the lateral surgical procedure.…”

“…However, this requires a specialized operating room, and the puncture route must be planned, which slightly increases operation time. In addition, the presence of the laser equipment over the surgical field interferes somewhat with the operation, which can introduce a certain degree of puncture error 23,24 . Among the patients in the laser-assisted group in our study, there were 2 cases of suboptimal drainage tube positioning.…”

Application of mixed reality navigation technology in primary brainstem hemorrhage puncture and drainage surgery: a case series and literature review

“…The conservative treatment strategy for PBH is mainly related to the hypertensive treatment strategy for ICH [11]. Since the primary damage of PBH is irreversible, surgical treatment is believed to relieve mechanical compression of the hematoma and prevent secondary injury, improving prognosis [1,12,13]. However, there have been some controversies about surgical treatment.…”

Three-dimensional laser combined with C-arm computed tomography-assisted puncture of intracerebral hemorrhage

“…The 3D APC function was used in the Xper APC automatic position control module to automatically position the rack movement to the angle displayed by the 3D reference image ( Figure 7 ) ( 9 ).…”