Free-hand stereotactic ventricular catheter insertion technique based on radio-anatomical landmarks. How I do it

BACKGROUND: Accurate ventricular catheter (VC) placement plays an important role in reducing the risk of ventriculoperitoneal shunt failure. Free-hand VC insertion is associated with a significant misplacement rate. Consequently, several expensive alternative methods that are unfortunately not available worldwide have been used. To overcome these limitations, we developed a simple surgical technique based on radio-anatomical landmarks aimed at reducing VC's misplacements.

METHOD: We reproduce the preoperative imaging on the patient's head using common anatomical landmarks. This allows defining stereotactic VC coordinates to be followed during the surgical procedure.

CONCLUSION: This simple and cost-effective method improves VC insertion accuracy.