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Lead cap localization using ultrasound in deep brain stimulation surgery: technical note.

D J Englot1, E F Chang, P S Larson

  • 1Department of Neurological Surgery, University of California, San Francisco, California 94143-0112, USA.

Minimally Invasive Neurosurgery : MIN
|April 21, 2011
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Summary

Portable ultrasound offers a safe and effective method for locating deep brain stimulation (DBS) lead caps during internal pulse generator (IPG) implantation, especially when palpation is difficult due to scalp swelling.

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Area of Science:

  • Neurosurgery
  • Medical Devices
  • Diagnostic Imaging

Background:

  • Deep brain stimulation (DBS) surgery involves implanting intracranial leads with caps that are tunneled subcutaneously.
  • Locating these lead caps by palpation is crucial for subsequent internal pulse generator (IPG) implantation.
  • Palpation can be challenging in cases of thick or edematous scalps, particularly when IPG implantation occurs on the same day as lead placement.

Purpose of the Study:

  • To evaluate the utility of portable ultrasound (US) as an alternative method for localizing DBS lead caps.
  • To address the limitations of palpation and fluoroscopy in identifying lead caps for IPG connection.

Main Methods:

  • Utilized readily available portable ultrasound machines in the operating room.
  • Employed ultrasound to visualize and accurately pinpoint the location of the lead cap prior to IPG implantation.

Main Results:

  • Portable ultrasound provides easy and accurate localization of the DBS lead cap.
  • Ultrasound overcomes the challenges associated with palpation in difficult scalp conditions.
  • It avoids the poor soft tissue visualization and radiation exposure associated with fluoroscopy.

Conclusions:

  • Portable ultrasound is a practical and effective tool for intraoperative localization of DBS lead caps.
  • This technique enhances surgical planning and execution for IPG implantation, improving patient and surgical team safety.