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Related Experiment Video

Updated: May 19, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

Pullout-proofing external ventricular drains.

Nathaniel L Whitney¹, Nathan R Selden

¹Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon 97239, USA.

Journal of Neurosurgery. Pediatrics

|August 7, 2012

Summary

This summary is machine-generated.

A novel modified Roman sandal technique securely anchors external ventricular drains (EVDs) using sutures, preventing dislodgement and reducing cerebrospinal fluid (CSF) leakage risks.

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Last Updated: May 19, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

Area of Science:

Neurosurgery
Medical Device Engineering

Background:

External ventricular drains (EVDs) are crucial for managing cerebrospinal fluid (CSF) pressure.
EVD dislodgement, leakage, and infection are significant clinical challenges.

Purpose of the Study:

To present a secure method for external ventricular drain (EVD) fixation.
To minimize complications such as drain pullout, CSF leakage, and infection.

Main Methods:

A modified Roman sandal technique utilizing a single permanent suture in a box stitch pattern.
Suture is secured around the EVD exit site, with multiple knots to prevent loosening and pullout.

Main Results:

Over 12 years in high-volume pediatric practice, only one drain breakage occurred.
No instances of drain pullout were reported using this technique.

Conclusions:

The modified Roman sandal technique provides robust fixation for EVDs, effectively preventing pullout.
The suture construct's integrity appears superior to the drain tubing itself.