Smart stylet: the development and use of a bedside external ventricular drain image-guidance system

Stereotact Funct Neurosurg. 2015;93(1):50-8. doi: 10.1159/000368906. Epub 2015 Jan 31.

Abstract

Background: Placement accuracy of ventriculostomy catheters is reported in a wide and variable range. Development of an efficient image-guidance system may improve physician performance and patient safety.

Objective: We evaluate the prototype of Smart Stylet, a new electromagnetic image-guidance system for use during bedside ventriculostomy.

Methods: Accuracy of the Smart Stylet system was assessed. System operators were evaluated for their ability to successfully target the ipsilateral frontal horn in a phantom model.

Results: Target registration error across 15 intracranial targets ranged from 1.3 to 4.6 mm (mean 3.1 mm). Using Smart Stylet guidance, a test operator successfully passed a ventriculostomy catheter to a shifted ipsilateral frontal horn 20/20 (100%) times from the frontal approach in a skull phantom. Without Smart Stylet guidance, the operator was successful 4/10 (40%) times from the right frontal approach and 6/10 (60%) times from the left frontal approach. In a separate experiment, resident operators were successful 2/4 (50%) times when targeting the shifted ipsilateral frontal horn with Smart Stylet guidance and 0/4 (0%) times without image guidance using a skull phantom.

Conclusions: Smart Stylet may improve the ability to successfully target the ventricles during frontal ventriculostomy.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Calibration
  • Catheters*
  • Electromagnetic Phenomena
  • Equipment Design
  • Fiducial Markers
  • Humans
  • Hydrocephalus / diagnostic imaging
  • Hydrocephalus / pathology
  • Hydrocephalus / surgery*
  • Imaging, Three-Dimensional*
  • In Vitro Techniques
  • Internship and Residency
  • Lateral Ventricles / diagnostic imaging
  • Lateral Ventricles / pathology
  • Lateral Ventricles / surgery*
  • Neuronavigation / instrumentation*
  • Neurosurgery / education
  • Phantoms, Imaging
  • Point-of-Care Systems*
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods*
  • Tomography, X-Ray Computed
  • User-Computer Interface
  • Ventriculostomy / instrumentation*