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Hollow mandrin facilitates external ventricular drainage placement.
O Heese1, J Regelsberger, U Kehler
1Department of Neurosurgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. heese@uke.uni-hamburg.de
Acta Neurochirurgica
|March 2, 2005
Summary
A new hollow mandrin system improves ventricular catheter placement, reducing punctures and risks. It allows real-time cerebrospinal fluid (CSF) flow observation and intracranial pressure (ICP) monitoring during neurosurgery.
Area of Science:
- Neurosurgery
- Medical Devices
- Neurological Monitoring
Background:
- Ventricular catheter placement is a standard neurosurgical procedure.
- Current methods rely on post-removal cerebrospinal fluid (CSF) flow observation for placement confirmation.
- Incorrect placement necessitates repeat punctures, increasing risks.
Purpose of the Study:
- To introduce a novel hollow mandrin device for ventricular catheter insertion.
- To enable real-time CSF flow visualization during the procedure.
- To facilitate immediate intracranial pressure (ICP) measurement.
Main Methods:
- A hollow mandrin with a blunt tip and side holes was developed.
- The mandrin aligns with the ventricular catheter, allowing CSF entry upon ventricle access.
- A connected tube enables ICP measurement without CSF loss.
Main Results:
- The system was used in 15 patients with subarachnoid or intraventricular hemorrhage.
- All 15 patients achieved correct catheter placement.
- ICP measurement was straightforward; low-pressure hydrocephalus cases were successfully managed with gentle aspiration.
Conclusions:
- The new technique reduces the need for multiple punctures, lowering risks of neural damage and hemorrhage.
- It allows monitoring of catheter depth, preventing over-insertion.
- Accurate ICP measurement is achievable without CSF loss.