scholarly journals Compared with conventional procedures performed via the occipital horn, an intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus

2019 ◽  
Author(s):  
AiJun Peng ◽  
Hai Zhao ◽  
YongKang Wu ◽  
Yi Zhao ◽  
LiangXue Zhou
Keyword(s):  
Navigation System ◽  
Catheter Placement ◽  
Intraoperative Navigation ◽  
Ventricular Catheter ◽  
Conventional Surgery ◽  
Navigation Surgery ◽  
Surgery Group ◽  
Ventriculoperitoneal Shunting ◽  
Catheter Obstruction ◽  
Evans Index

Abstract Background: Ventriculoperitoneal shunting (VPS) is a common neurosurgical procedure used to treat hydrocephalus. Catheter obstruction is one of the most common factors that influences patient prognosis. We therefore evaluated the accuracy of proximal catheter placement and explored the probable relationship between ventricular catheter obstruction and both symptom grade and postoperative Evans index between an intraoperative navigation system for VPS and conventional surgery via the occipital horn. Methods: We performed a retrospective study of 33 patients with VPS (the navigation surgery group) and 26 patients with VPS (the conventional surgery group) seen between January 2012 and August 2018. The clinical data, follow-up times, catheterization accuracy, postoperative outcomes, cumulative survival times and correlations between catheter placement and obstruction, symptom grade and the postoperative Evans index were analyzed. Results: Thirty-one patients experienced optimal ventricular catheter placement (grade 1), 2 experienced suboptimal placement (grade 2), and none experienced poor ventricular catheter placement (grade 3) in the navigation surgery group, whereas 6, 14, and 6 patients, respectively, had these results in the conventional surgery group. Greater improvement was observed in postoperative symptoms (P=0.017), including less catheter readjustment (P<0.001), in the navigation surgery group. A Kaplan-Meier survival analysis showed that the cumulative catheter obstruction-free survival time was longer in the navigation surgery group than in the conventional surgery group (P=0.028). Moreover, catheter placement was significantly correlated with catheter obstruction (P<0.001). In addition, catheter obstruction was significantly correlated with the symptom grade (P=0.001) and postoperative Evans index (P<0.001). Conclusions: An intraoperative navigation system for VPS improved patient outcomes and the accuracy of ventricular catheter placement. Catheter obstruction-free survival times were longer in the navigation surgery group, and catheter placement was significantly correlated with catheter obstruction.

scholarly journals Compared with conventional procedures performed via the occipital horn, an intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus

2019 ◽  
Author(s):  
Aijun Peng ◽  
Hai Zhao ◽  
Yongkang Wu ◽  
Yi Zhao ◽  
Liangxue Zhou
Keyword(s):  
Navigation System ◽  
Catheter Placement ◽  
Intraoperative Navigation ◽  
Ventricular Catheter ◽  
Conventional Surgery ◽  
Navigation Surgery ◽  
Surgery Group ◽  
Ventriculoperitoneal Shunting ◽  
Catheter Obstruction ◽  
Evans Index

Abstract Background: Ventriculoperitoneal shunting (VPS) is a common neurosurgical procedure for treating hydrocephalus. Catheter obstruction is one of the most common factors that influences patient prognosis. We evaluated the accuracy of proximal catheter placement and explored the probable relationship between ventricular catheter obstruction and both symptom grade and postoperative Evans index between an intraoperative navigation system for VPS and conventional surgery via the occipital horn. Methods: We performed a retrospective study of 33 patients with VPS (he navigation surgery group) and 26 patients with VPS (the conventional surgery group) seen between January 2012 and August 2018. The clinical data, follow-up times, catheterization accuracy, postoperative outcomes, cumulative survival times and correlations between catheter placement and obstruction, symptom grade and the postoperative Evans index. Results: Thirty-one patients experienced optimal ventricular catheter placement (grade 1), 2 experienced suboptimal placement (grade 2), and none experienced poor ventricular catheter placement (grade 3) in the navigation surgery group, whereas 6, 14, and 6 patients, respectively, had these results in the conventional surgery group. There was greater improvement in postoperative symptoms (P=0.017), including less catheter readjustment (P<0.001), in the navigation surgery group. Kaplan-Meier survival analysis showed that the cumulative catheter obstruction-free survival time was longer in the navigation surgery group than in the conventional surgery group (P=0.028). Catheter placement was significantly correlated with catheter obstruction (P<0.001). In addition, catheter obstruction was significantly correlated with the symptom grade (P=0.001) and postoperative Evans index (P<0.001). Conclusions: An intraoperative navigation system for VPS improved patient outcomes and the accuracy of ventricular catheter placement. Catheter obstruction-free survival times were longer in the navigation surgery group, and catheter placement was significantly correlated with catheter obstruction.

scholarly journals Intraoperative navigation system for ventriculoperitoneal shunting improves outcomes in patients with hydrocephalus compared with conventional procedures via the occipital horn

2019 ◽  
Author(s):  
Aijun Peng ◽  
Hai Zhao ◽  
Yongkang Wu ◽  
Yi Zhao ◽  
Liangxue Zhou
Keyword(s):  
Survival Time ◽  
Catheter Placement ◽  
Intraoperative Navigation ◽  
Ventricular Catheter ◽  
Conventional Surgery ◽  
Navigation Surgery ◽  
Surgery Group ◽  
Ventriculoperitoneal Shunting ◽  
Catheter Obstruction ◽  
Evans Index

Abstract Background: Ventriculoperitoneal shunting (VPS) is a common neurosurgical procedure for treating hydrocephalus. Catheter obstruction is one of the most common factors influencing patient prognosis. We evaluated the possibility of improving the accuracy of proximal catheter placement and the probable relationship of ventricular catheter obstruction with the symptom grade and postoperative Evans index with intraoperative navigation for VPS compared with conventional surgery via the occipital horn. Method: We performed a retrospective study including 33 patients with VPS in the navigation surgery group and 26 patients with VPS in the conventional surgery group between January 2012 and August 2018. The clinical data, follow-up time, catheterization accuracy, postoperative outcomes, cumulative survival time and correlations of catheter placement with obstruction and of catheter obstruction with the symptom grade and postoperative Evans index were analyzed. Results: Thirty-one patients experienced optimal ventricular catheter placement (grade 1), 2 patients experienced suboptimal placement (grade 2), and no patients experienced poor ventricular catheter placement (grade 3) in the navigation surgery group compared with 6, 14, and 6 patients, respectively, in the conventional surgery group. Greater improvement in postoperative symptoms (P=0.017) was observed in the navigation surgery group, including less catheter readjustment (P<0.001). Kaplan-Meier survival analysis showed that the cumulative catheter obstruction-free survival time was longer in the navigation surgery group than in the conventional surgery group (P=0.028). Catheter placement was significantly correlated with catheter obstruction (P<0.001). In addition, catheter obstruction was significantly correlated with the symptom grade (P=0.001) and postoperative Evans index (P<0.001). Conclusions: The intraoperative navigation system for VPS improved patient outcomes and the accuracy of ventricular catheter placement. Catheter obstruction-free survival time was longer in the navigation surgery group, and catheter placement was significantly correlated with catheter obstruction.

Ultrasound-Guided Insertion of the Ventricular Catheter in Ventriculoperitoneal Shunt Surgery: Evaluation of Accuracy and Feasibility in a Prospective Cohort

2020 ◽  
Vol 82 (01) ◽  
pp. 009-017
Author(s):  
Severina Leu ◽  
Maria Kamenova ◽  
Luigi Mariani ◽  
Jehuda Soleman
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Perioperative Complications ◽  
Univariate Analysis ◽  
Ventricular Catheter ◽  
Neurosurgical Procedures ◽  
Anatomical Landmarks ◽  
Ultrasound Guided ◽  
The Us ◽  
Evans Index ◽  
Shunt Survival

Abstract Objective Ventriculoperitoneal shunt (VPS) placement is one of the most frequent neurosurgical procedures. The position of the proximal catheter is important for shunt survival. Shunt placement is done either without image guidance (“freehand”) according to anatomical landmarks or by use of various image-guided techniques. Studies evaluating ultrasound-guided (US-G) VPS placement are sparse. We evaluate the accuracy and feasibility of US-G VPS placement, and compare it to freehand VPS placement. Methods We prospectively collected data of consecutive patients undergoing US-G VPS placement. Thereafter, the US cohort was compared with a cohort of patients in whom VPS was inserted using the freehand technique (freehand cohort). Primary outcome was accuracy of catheter positioning, and secondary outcomes were postoperative improvement in Evans' index (EI), rates of shunt dysfunction and revision surgery, perioperative complications, as well as operation, and anesthesia times. Results We included 15 patients undergoing US-G VPS insertion. Rates of optimally placed shunts were higher in the US cohort (67 vs. 49%, p = 0.28), whereas there were no malpositioned VPS (0%) in the US cohort, compared with 10 (5.8%) in the freehand cohort (p = 0.422). None of the factors in the univariate analysis showed significant association with nonoptimal (NOC) VPS placement in the US cohort. The mean EI improvement was significantly better in the US cohort than in the freehand cohort (0.043 vs. 0.014, p = 0.035). Conclusion Based on our preliminary results, US-G VPS placement seems to be feasible, safe, and increases the rate of optimally placed catheters.

scholarly journals Use of an intraoperative navigation system and piezoelectric surgery for styloidectomy in a patient with Eagle’s syndrome: a case report

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Shintaro Sukegawa ◽  
Takahiro Kanno ◽  
Akio Yoshimoto ◽  
Kenichi Matsumoto ◽  
Yuka Sukegawa-Takahashi ◽  
...  
Keyword(s):  
Case Report ◽  
Navigation System ◽  
Intraoperative Navigation ◽  
Eagle’S Syndrome ◽  
Piezoelectric Surgery

A guide to placement of parietooccipital ventricular catheters

1995 ◽  
Vol 82 (2) ◽  
pp. 300-304 ◽  
Author(s):  
Matthew A. Howard ◽  
Jayashree Srinivasan ◽  
Carl G. Bevering ◽  
H. Richard Winn ◽  
M. Sean Grady
Keyword(s):  
Ct Scanning ◽  
Catheter Placement ◽  
Target Point ◽  
Catheter Position ◽  
Content Type ◽  
Ventriculoperitoneal Shunting ◽  
Frontal Horn ◽  
Catheter Tip ◽  
Ventricular Catheters ◽  
Entire Procedure

✓ Accurate placement of parietooccipital ventricular catheters can be difficult and frustrating. To minimize the morbidity of the procedure and lengthen the duration of shunt function, the catheter tip should lie in the ipsilateral frontal horn. The authors describe a posterior ventricular guide (PVG) for placement of parietooccipital catheters that operates by mechanically coupling the posterior burr hole to the anterior target point. In a series of 38 patients who underwent ventriculoperitoneal shunting with the assistance of the guide, postoperative computerized tomography (CT) scanning revealed that 35 (92.0%) had accurate catheter placement. In comparison, a retrospective review of free-hand posterior catheter placement revealed good catheter position in only 22 of 43 patients (51.1%). The use of the guide added less than 5 minutes to the entire procedure, and there were no complications related to its use. The PVG is a simple and useful tool that aids in the placement of parietooccipital ventricular catheters.

scholarly journals Intraoperative Fiber-Optic Endoscopy for Ventricular Catheter Insertion

2001 ◽  
Vol 28 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Philip V. Theodosopoulos ◽  
Aviva Abosch ◽  
Michael W. McDermott
Keyword(s):  
Fiber Optic ◽  
Catheter Placement ◽  
Ventricular Catheter ◽  
Neurosurgical Procedure ◽  
Significant Difference ◽  
Catheter Tip ◽  
Endoscopic Guidance ◽  
Ventricular Catheters ◽  
Tip Position ◽  
Optic Endoscopy

ABSTRACT:Objective:Ventricular catheter placement is a common neurosurgical procedure often resulting in inaccurate intraventricular positioning. We conducted a comparison of the accuracy of endoscopic and conventional ventricular catheter placement in adults.Methods:A retrospective analysis of data was performed on 37 consecutive patients undergoing ventriculo-peritoneal shunt (VPS) insertion with endoscopy and 40 randomly selected, unmatched patients undergoing VPS insertion without endoscopy, for the treatment of hydrocephalus of varied etiology. A grading system for catheter tip position was developed consisting of five intraventricular zones, V1-V5, and three intraparenchymal zones, A, B, C. Zones V1 for the frontal approaches and V1 or V2 for the occipital approaches were the optimal catheter tip locations. Postoperative scans of each patient were used to grade the accuracy of ventricular catheter placement.Results:Seventy-six percent of all endoscopic ventricular catheters were in zone V1 and 100% were within zones V1-V3. No endoscopically inserted catheters were observed in zones V4, V5 or intraparenchymally. Thirty-eight percent of the conventionally placed catheters were in zone V1, 53% in zones V1-3 and 15% intraparenchymally. There was a statistically significant difference in the percentage of catheters in optimal location versus in any other location, favoring endoscopic guidance (p<0.001).Conclusion:We conclude that endoscopic ventricular catheter placement provides improved positioning accuracy than conventional techniques.

scholarly journals Selective Infracolic Omentecomy and Fixation Reduces Complications after Laparoscopic Assisted Peritoneal Dialysis Catheter Placement

2018 ◽  
Vol I (1) ◽  
pp. 06-11
Author(s):  
Andries Ryckx
Keyword(s):  
Peritoneal Dialysis ◽  
Catheter Placement ◽  
P Value ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Exit Site ◽  
Exit Site Infection ◽  
Catheter Survival ◽  
Catheter Obstruction ◽  
Infracolic Omentectomy

Introduction Peritoneal dialysis (PD) as a treatment for patients with end-stage renal disease (ESRD) provides a competitive alternative to hemodialysis (HD). Long-term catheter survival remains challenging and techniques are not standardized. Advanced laparoscopic placement with fixation and omentectomy might increase catheter survival. The goal of our study was to evaluate if selective infracolic omentectomy and fixation reduced complications after CAPD catheter placement. Materials and Methods A prospective database of patients with CAPD catheter placement from March 2004 to March 2015 was analyzed. All procedures were performed laparoscopically assisted and under general anesthesia by a single surgeon. 78 patients were included, there were no exclusion criteria. Statistical analysis was performed with SPSS. Fisher exact test and log-rank test with calculation of P-value was executed. P-value of <0.05 was considered significant. Results Of the 78 patients who underwent catheter placement, 53 (68%) were males and 25 (32%) were females. The mean age was 54 (ranged from 13 to 88 years). Selective infracolic omentectomy was performed in 32 patients if the momentum reached beyond the promontory. Non-resorbable sutures to fix the catheter were applied in 33 patients. The average duration of peritoneal dialysis was 21 months (range from ten days to 84 months). Omentectomy significantly reduced the incidence of catheter obstruction (3 vs. 11%, P=0.028) but not of catheter dislocation (19 vs. 30%, P=0.101). Omentectomy did not significantly increase the incidence of peritonitis (22 vs. 31%,P=0.133) or exit-site infection (16vs 17%, P=0.238). Catheter fixation with non-resorbable sutures reduced catheter dislocation (21 vs. 23%, P=0.226) and catheter obstruction( 12 vs.17%,P=0.223) with a significant reduction of peritonitis (15 vs. 29%, P=0.044) and no effect on exit-site infection (15 vs. 17%,P=0.251). Conclusion Laparoscopic PD catheter placement with selective omentectomy and fixation of the catheter to the abdominal wall is safe and feasible and leads to fewer complications. Key words: peritoneal, dialysis, catheter, complications, laparoscopy, omentectomy.

scholarly journals Relationship of the Location of the Ventricular Catheter Tip and Function of the Ventriculoperitoneal Shunt

2019 ◽  
Vol 9 (1) ◽  
pp. 16-21
Author(s):  
DM Arman ◽  
Sheikh Muhammad Ekramullah ◽  
Sudipta Kumer Mukherjee ◽  
Joynul Islam ◽  
Mirza Hafizur Rashid ◽  
...  
Keyword(s):  
Ventriculoperitoneal Shunt ◽  
Significant Proportion ◽  
Catheter Placement ◽  
Ventricular Catheter ◽  
Shunt Procedure ◽  
Freehand Technique ◽  
Catheter Tip ◽  
And Function ◽  
Relationship Of ◽  
The Relationship

Object: The objective of this study was to determine the relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt. Methods: This prospective observational study included 140 patients from a single institution who underwent a ventriculoperitoneal shunt procedure in which a new ventricular catheter was placed between September, 2013 and September 2016. Data abstracted for each patient included age, sex, diagnosis, site and side of ventricular catheter placement. Postoperative CT scan images were reviewed for accuracy of ventricular catheter placement. Patients were followed up over 2 ½ to 4 ½ years.63 patients were available for follow up. We lost communication with rest of the patients. The relationship of the location of the ventricular catheter tip and function of the ventriculoperitoneal shunt was analyzed in 63 patients. Results: There were 140 patients included in the study; accuracy ventricular catheter tip placement were 55 (39.28%) using freehand technique. VP shunt functioned well in 43 (68.25%) of 63 patients. Among the 43 patients with well functioning shunt ,19 were in accurate group ,7 were in suboptimal group and 17 were in inaccurate group.26 patients (41.27%) had good outcome with normal development and normal IQ Conclusions: Mechanical malfunction and infection are the most significant problems associated with shunts for the treatment of hydrocephalus. Above all, a significant proportion of shunt failure was due to obstruction of the ventricular catheter, and accurate placement of the shunt catheter is highly important to reduce the incidence of shunt malfunction. Bang. J Neurosurgery 2019; 9(1): 16-21

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