Free-hand stereotactic ventricular catheter insertion technique based on radio-anatomical landmarks. How I do it

Background Accurate ventricular catheter (VC) placement plays an important role in reducing the risk of ventriculoperitoneal shunt failure. Free-hand VC insertion is associated with a significant misplacement rate. Consequently, several expensive alternative methods that are unfortunately not available worldwide have been used. To overcome these limitations, we developed a simple surgical technique based on radio-anatomical landmarks aimed at reducing VC’s misplacements. Method We reproduce the preoperative imaging on the patient’s head using common anatomical landmarks. This allows defining stereotactic VC coordinates to be followed during the surgical procedure. Conclusion This simple and cost-effective method improves VC insertion accuracy.