Robotic catheter ventriculostomy: feasibility, efficacy, and implications

Lollis, S. Scott; Roberts, David W.

doi:10.3171/jns/2008/108/2/0269

Cited by 42 publications

(29 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,[8][9][10] In the present study we describe the use of the SurgiScope robotic frameless image guidance system, which has been shown to be safe and accurate in the placement of ventricular catheters in the setting of small ventricles. 6 This system allows the safe and accurate placement of depth electrodes in an efficient manner while obviating the need to reposition the patient, remove the frame, or reprepare and redrape the patient. The efficiency of this frameless and noniterative guide positioning is especially appreciated with multiple depth electrode placement.…”

Section: Discussionmentioning

confidence: 99%

Robotic image-guided depth electrode implantation in the evaluation of medically intractable epilepsy

Spire¹,

Jobst²,

Thadani³

et al. 2008

FOC

Self Cite

View full text Add to dashboard Cite

Object The authors describe their experience with a technique for robotic implantation of depth electrodes in patients concurrently undergoing craniotomy and placement of subdural monitoring electrodes for the evaluation of intractable epilepsy. Methods Patients included in this study underwent evaluation in the Dartmouth Surgical Epilepsy Program and were recommended for invasive seizure monitoring with depth electrodes between 2006 and the present. In all cases an image-guided robotic system was used during craniotomy for concurrent subdural grid electrode placement. A total of 7 electrodes were placed in 4 patients within the time period. Results Three of 4 patients had successful localization of seizure onset, and 2 underwent subsequent resection. Of the patients who underwent resection, 1 is now seizure free, and the second has only auras. There was 1 complication after subpial grid placement but no complications related to the depth electrodes. Conclusions Robotic image-guided placement of depth electrodes with concurrent craniotomy is feasible, and the technique is safe, accurate, and efficient.

show abstract

Section: Discussionmentioning

confidence: 99%

Robotic image-guided depth electrode implantation in the evaluation of medically intractable epilepsy

Spire¹,

Jobst²,

Thadani³

et al. 2008

FOC

Self Cite

View full text Add to dashboard Cite

show abstract

“…Both frame-based and frameless stereotactic techniques have been shown to be useful in the treatment of IIH [17,18,19] including robotic technology [20,21]. Electromagnetic (EM) navigation which can be performed without rigid head fixation has been used for various indications in neurosurgery [22,23,24,25,26,27,28].…”

Section: Introductionmentioning

confidence: 99%

Shunt Surgery in Idiopathic Intracranial Hypertension Aided by Electromagnetic Navigation

Hermann¹,

Polemikos²,

Heissler³

et al. 2017

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background: Idiopathic intracranial hypertension (IIH) is characterized by increased cerebrospinal fluid (CSF) pressure and normal or slit ventricles. Lumboperitoneal shunting had been favored by many investigators for CSF diversion in IIH for decades; however, it has been associated with various side effects. Because of the small ventricular size adequate positioning of a ventricular catheter is challenging. Objectives: Here, we investigated the usefulness of electromagnetic (EM)-guided ventricular catheter placement for ventriculoperitoneal shunting in IIH. Methods: Eighteen patients with IIH were included in this study. The age of patients ranged from 5 to 58 years at the time of surgery (mean age: 31.8 years; median: 29 years). There were 2 children (5 and 11 years old) and 16 adults. Inclusion criteria for the study were an established clinical diagnosis of IIH, lack of improvement with medication, and the presence of small ventricles. In all patients EM-navigated placement of the ventricular catheter was performed using real-time tracking of the catheter tip for exact positioning close to the foramen of Monro. Postoperative CT scans were correlated with intraoperative screen shots to validate the position of the catheter. Results: In all patients EM-navigated ventricular catheter placement was achieved with a single pass. There were no intraoperative or postoperative complications. Postoperative imaging confirmed satisfactory positioning of the ventricular catheter. No proximal shunt failure was observed during the follow-up at a mean of 41.5 months (range: 7-90 months, median: 40.5 months). Conclusions: EM-navigated ventricular catheter placement in shunting for IIH is a safe and straightforward technique. It obviates the need for sharp head fixation, the head of the patient can be moved during surgery, and it may reduce the revision rate during follow-up.

show abstract

“…22,24,33,40,41 Thomale et al have described a fixedframe guidance system comprised of a rigid arc, catheter guide tube, and coordinates calculated with smartphone software analyzing an uploaded DICOM image. 42 To date, ultrasound-image assisted ventricular catheter placement has predominantly occurred in the intraoperative setting.…”

Section: Comparison With Existing Technology and Device Limitationsmentioning

confidence: 99%

“…28,29,31 Endoscope technology provides confirmation of ventricular entry but does not assist with the choice of initial trajectory. 22,33,41,42 CT or MR image guidance is useful for the dynamic choice of trajectory, yet involves a relatively long setup time, and portability of equipment outside of the operating room can be a challenge. 11,15,18,45 Furthermore, such image guidance relies on a static prior image rather than a current picture of ventricular boundaries.…”

mentioning

confidence: 99%

Ultrasound stylet for non-image-guided ventricular catheterization

Coulson¹,

Chiarelli

et al. 2015

PED

View full text Add to dashboard Cite

OBJECT Urgent ventriculostomy placement can be a lifesaving procedure in the setting of hydrocephalus or elevated intracranial pressure. While external ventricular drain (EVD) insertion is common, there remains a high rate of suboptimal drain placement. Here, the authors seek to demonstrate the feasibility of an ultrasound-based guidance system that can be inserted into an existing EVD catheter to provide a linear ultrasound trace that guides the user toward the ventricle. METHODS The ultrasound stylet was constructed as a thin metal tube, with dimensions equivalent to standard catheter stylets, bearing a single-element, ceramic ultrasound transducer at the tip. Ultrasound backscatter signals from the porcine ventricle were processed by custom electronics to offer real-time information about ventricular location relative to the catheter. Data collected from the prototype device were compared with reference measurements obtained using standard clinical ultrasound imaging. RESULTS A study of porcine ventricular catheterization using the experimental device yielded a high rate of successful catheter placement after a single pass (10 of 12 trials), despite the small size of pig ventricles and the lack of prior instruction on porcine ventricular architecture. A characteristic double-peak signal was identified, which originated from ultrasound reflections off of the near and far ventricular walls. Ventricular dimensions, as obtained from the width between peaks, were in agreement with standard ultrasound reference measurements (p < 0.05). Furthermore, linear ultrasound backscatter data permitted in situ measurement of the stylet distance to the ventricular wall (p < 0.05), which assisted in catheter guidance. CONCLUSIONS The authors have demonstrated the ability of the prototype ultrasound stylet to guide ventricular access in the porcine brain. The alternative design of the device makes it potentially easy to integrate into the standard workflow for bedside EVD placement. The availability of a fast, easy-to-use, inexpensive guidance system can play a role in reducing the complication rate for EVD placement.

show abstract

Robotic catheter ventriculostomy: feasibility, efficacy, and implications

Cited by 42 publications

References 23 publications

Robotic image-guided depth electrode implantation in the evaluation of medically intractable epilepsy

Robotic image-guided depth electrode implantation in the evaluation of medically intractable epilepsy

Shunt Surgery in Idiopathic Intracranial Hypertension Aided by Electromagnetic Navigation

Ultrasound stylet for non-image-guided ventricular catheterization

Contact Info

Product

Resources

About