A Novel Simple Puncture Positioning and Guidance System for Intracerebral Hematoma

World Neurosurg. 2019 Nov:131:e562-e569. doi: 10.1016/j.wneu.2019.07.235. Epub 2019 Aug 7.

Abstract

Background: Minimally invasive surgical techniques may have beneficial effects on spontaneous intracerebral hemorrhage. Accurate localization of the hematoma and real-time guided puncture are more important in minimally invasive surgical procedures than in traditional craniotomy. Here, we introduce a novel simple puncture positioning and guidance system for intracerebral hematoma and demonstrate its utility for hematoma puncture surgery in a simulation experiment and series of patients.

Methods: We describe the device and use of the technique for hematoma puncture surgery in basal ganglia hematomas and report on the precision of the simulation experiments compared to that of freehand puncture, as well as its clinical application in 16 cases.

Results: The accuracy of this technique was superior to that of freehand puncture. All 16 patients underwent successful puncturing of the hematoma cavity or ventricles only once without any related complications.

Conclusions: We demonstrate a novel simple puncture positioning and guidance system that has the advantages of simplicity, low-cost, device availability, and individual real-time guidance. We believe this system may be useful in resource-limited centers where navigation is not available.

Keywords: Basal ganglia; Guided puncture; Intracerebral hematoma; Surgery.

MeSH terms

  • Adult
  • Aged
  • Basal Ganglia Hemorrhage / surgery*
  • Cerebral Hemorrhage / surgery
  • Cerebral Intraventricular Hemorrhage / surgery*
  • Drainage / methods*
  • Female
  • Hematoma / surgery*
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods*
  • Punctures / methods*
  • Surgery, Computer-Assisted