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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Accuracy of augmented reality-guided (AR) drainage versus stereotactic and freehand puncture in intracerebral haemorrhage

Genauigkeit Augmented Reality (AR) geführter Darianagenanlage versus stereotaktischer und freihändiger Implantation bei intracerebralen Hamatömen

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  • presenting/speaker Peter Christoph Reinacher - Universitätsklinikum Freiburg, Abteilung Stereotaktische und Funktionelle Neurochirurgie, Freiburg i. Br., Deutschland; Fraunhofer Institut für Lasertechnik (ILT), Aachen, Deutschland
  • Amin Stanicki - Universitätsklinikum Freiburg, Abteilung Stereotaktische und Funktionelle Neurochirurgie, Freiburg i. Br., Deutschland
  • Roland Rölz - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Mateo Nunez - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Marco Bissolo - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Christine Steiert - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Panagiotis Fistouris - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Volker Arnd Coenen - Universitätsklinikum Freiburg, Abteilung Stereotaktische und Funktionelle Neurochirurgie, Freiburg i. Br., Deutschland
  • Horst Urbach - Universitätsklinikum Freiburg, Neuroradiologische Klinik, Freiburg i. Br., Deutschland
  • Christian Fung - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Jürgen Beck - Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Freiburg i. Br., Deutschland
  • Theo Demerath - Universitätsklinikum Freiburg, Neuroradiologische Klinik, Freiburg i. Br., Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV130

doi: 10.3205/22dgnc130, urn:nbn:de:0183-22dgnc1307

Published: May 25, 2022

© 2022 Reinacher et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Minimally-invasive intracranial drain placement is a common neurosurgical emergency procedure in patients with intracerebral hemorrhage (ICH). We aimed to retrospectively investigate the accuracy of conventional (bedside) hemorrhage drain placement and to prospectively compare the accuracy of augmented/mixed reality-guided (AR) versus stereotactic-guided (STX) and conventional drain placement in a phantom model.

Methods: A retrospective, single-center analysis evaluated the accuracy of drain placement in 73 consecutive ICH with a visual rating of postinterventional computed tomography data. In a head phantom with a simulated deep ICH, five neurosurgeons performed four punctures for each technique: STX, AR and the conventional freehand technique in randomized sequence (60 operations). The Euclidean distance to the target point and the lateral deviation of the achieved trajectory from the planned trajectory at target point level were compared between the three methods.

Results: Analysis of the clinical cases revealed an optimal drainage position in only 46/73 (63%). Correction of the drain was necessary in 23/73 cases (32%). In the phantom study, accuracy of AR was significantly higher than the conventional method (p < 0.001 for both Euclidean and lateral distances). The Euclidean distance using AR (median 3 mm) was close to that using STX (median 1.95 mm; p = 0.023).

Conclusion: We demonstrated that the accuracy of the conventional technique was low and that subsequent position correction was common. In a phantom model, AR drainage placement was significantly more precise than the conventional method. AR has great potential to increase precision of emergency intracranial punctures in a bedside setting.

Figure 1 [Fig. 1], Figure 2 [Fig. 2]