caa a22 4500 606215476 CHVBK 20210128101059.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00701-015-2349-0 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2349-0 Guiding protractor for accurate freehand placement of ventricular catheter in ventriculoperitoneal shunting [Elektronische Daten] [Donghan Kim, Wonsoo Son, Jaechan Park] Background: While frameless stereotaxis can be used for shunt ventricular catheter placement in patients with smaller ventricles, the ventricular catheter is still commonly placed based on the surface anatomy of the head for patients with larger ventricles. Thus, surgical techniques and guides facilitating accurate and reliable freehand placement of the ventricular catheter still need to be devised. Methods: With the patient in a supine position and the axis of their head maintained horizontally, the guiding protractor is placed horizontally in the frontal burrhole at Kocher's point. Using the guiding angle between the head axis and the frontal horn of the lateral ventricle based on coronal head computed tomography (CT) or magnetic resonance (MR) images, the ventricular catheter is then placed in the catheter guide within the guiding protractor. Results: In 20 hydrocephalic patients with a bicaudate index >0.2 or bifrontal distance >25mm, the ideal guiding angle ranged from 17 to 23° (mean ± standard deviation [SD], 19.6° ± 1.6°). In all these patients, ventricular catheterization was successfully achieved with only one pass of the catheter, and postoperative CT scans showed satisfactory placement of the catheter in the ipsilateral frontal horn of the lateral ventricles. Conclusions: The proposed surgical technique using a guiding protractor facilitates accurate freehand placement of a ventricular catheter for patients with a bicaudate index >0.2 or bifrontal distance >25mm. Springer-Verlag Wien, 2015 Catheterization nationallicence Cerebral ventricles nationallicence Guiding device nationallicence Hydrocephalus nationallicence Ventriculoperitoneal shunt nationallicence Kim Donghan Department of Neurosurgery, Research Center for Neurosurgical Robotic Systems, Kyungpook National University, 50, Samduk 2-ga, Jung-gu, 700-721, Daegu, Republic of Korea aut Son Wonsoo Department of Neurosurgery, Research Center for Neurosurgical Robotic Systems, Kyungpook National University, 50, Samduk 2-ga, Jung-gu, 700-721, Daegu, Republic of Korea aut Park Jaechan Department of Neurosurgery, Research Center for Neurosurgical Robotic Systems, Kyungpook National University, 50, Samduk 2-ga, Jung-gu, 700-721, Daegu, Republic of Korea aut Acta Neurochirurgica Springer Vienna 157/4(2015-04-01), 699-702 0001-6268 157:4<699 2015 157 701 https://doi.org/10.1007/s00701-015-2349-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 brief-communication jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2349-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kim Donghan Department of Neurosurgery, Research Center for Neurosurgical Robotic Systems, Kyungpook National University, 50, Samduk 2-ga, Jung-gu, 700-721, Daegu, Republic of Korea aut NATIONALLICENCE 700 1- Son Wonsoo Department of Neurosurgery, Research Center for Neurosurgical Robotic Systems, Kyungpook National University, 50, Samduk 2-ga, Jung-gu, 700-721, Daegu, Republic of Korea aut NATIONALLICENCE 700 1- Park Jaechan Department of Neurosurgery, Research Center for Neurosurgical Robotic Systems, Kyungpook National University, 50, Samduk 2-ga, Jung-gu, 700-721, Daegu, Republic of Korea aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/4(2015-04-01), 699-702 0001-6268 157:4<699 2015 157 701