RESULTS OF VENTRICULOPERITONEAL SHUNT SURGERY USING ELECTROMAGNETIC AND OPTICAL NAVIGATION: EXPERIENCES IN 31 PATIENTS
Objective: The ventriculoperitoneal (VP) shunt procedure is frequently performed in the field of neurosurgery to treat pathologies such as normal-pressure hydrocephalus, infection, trauma, or VP shunt dependency after subarachnoid haemorrhage. Although the precise impact of ventricular catheter plac...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Istanbul University Press
2024-10-01
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| Series: | İstanbul Tıp Fakültesi Dergisi |
| Subjects: | |
| Online Access: | https://cdn.istanbul.edu.tr/file/JTA6CLJ8T5/04FA0547393845C8858152518C13DCB8 |
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| Summary: | Objective: The ventriculoperitoneal (VP) shunt procedure is frequently performed in the field of neurosurgery to treat pathologies such as normal-pressure hydrocephalus, infection, trauma, or VP shunt dependency after subarachnoid haemorrhage. Although the precise impact of ventricular catheter placement on shunt dysfunction remains not fully elucidated, it is well established that a shunt catheter bypassing the ventricle will lead to shunt dysfunction shortly after placement. Therefore, navigation- assisted shunt surgery gains significance in order to reduce the number of cannulation attempts and for inserting the ventricle catheter in the proper position compared to free hand catheter placement.Material and Method: This retrospective study enrolled 31 patients who underwent VP shunt placement in two different clinics by two different surgeons using electromagnetic and optical navigation between 2016 and 2023. The study population was grouped into two. In the first group, 16 patients underwent VP shunt surgery using stereotactic optical navigation and also Strata (Medtronic, Minneapolis, USA) programmable valve in Liv Hospital, İstanbul. In the second group, 15 patients were operated using EM navigation and Codman Certas (Integra Lifesciences, New Jersey, USA) programmable valve in Florence Nightingale Hospital, İstanbul.Result: The age range of patients was 36 to 87 years, with a mean age of (73.74±9.06). Twelve of the patients participating in the study were male, and 19 were female. All patients were operated because of normal-pressure hydrocephalus. In the EM navigation group, there were 7 grade I and 8 grade II patients, and in the optical navigation group, there were 13 grade I and 3 grade II patients according to the postoperative CT findings and the radiological scale defined by Hayhurst. In three patients from the EM Navigation group, subdural effusion developed due to overdrainage in different shunt settings. In none of these three patients an additional surgical intervention was needed. There were no intraparenchymal haemorrhage or shunt dysfunction complications in our study.Conclusion: The use of navigation in shunt surgery prevents proximal failure and reduces the complications of intraparenchymal haemorrhage and shunt dysfunction. Although the use of optical navigation requires the use of a pinned headrest and an extended preoperative preparation time, the accuracy of ventricular catheter placement is similar when using optical navigation and EM navigation, despite these disadvantages. Due to its cost-effectiveness and high accuracy, the optically guided navigation system can be used in shunt surgery, especially considering the extra cost of the electromagnetic neuronavigation system. |
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| ISSN: | 1305-6441 |