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App-assisted external ventricular drain insertion.

Behzad Eftekhar¹

¹Department of Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney; and Department of Neurosurgery, Nepean Hospital, University of Sydney, New South Wales, Australia.

Journal of Neurosurgery

|December 15, 2015

Summary

Augmented reality (AR) smartphone applications like Sina can improve external ventricular drain (EVD) insertion by offering patient-specific guidance. This technique enhances precision compared to traditional freehand methods.

Keywords:

Android app EVD = external ventricular drain OR = operating room app = mobile device application augmented reality diagnostic and operative techniques external ventricular drain image-guided surgery neuronavigation

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Area of Science:

Neurosurgery
Medical Imaging
Augmented Reality

Background:

Traditional freehand external ventricular drain (EVD) insertion relies on fixed anatomical landmarks, neglecting patient-specific variations.
Augmented reality (AR) offers a potential solution for a more personalized approach to neurosurgical procedures.

Purpose of the Study:

To introduce and evaluate the Sina neurosurgical assist application for intraoperative planning and guidance during EVD insertion.
To assess the clinical feasibility, ease of use, and precision of AR-assisted EVD placement.

Main Methods:

Development of the Sina Android application, which overlays patient CT/MRI images onto the live camera view.
Intraoperative use by a surgeon with an assistant managing the AR device for guidance during EVD insertion.
Ex vivo studies to evaluate the precision and usability of the Sina application.

Main Results:

Successful clinical application of Sina-assisted EVD insertion in 5 cases.
Ex vivo studies demonstrated the ease of use and precision of the AR technique.
The Sina app provided guidance and continuous monitoring during the EVD placement procedure.

Conclusions:

Sina-assisted EVD insertion represents a patient-tailored approach that overcomes limitations of the freehand technique.
The AR-based method shows potential for improving accuracy and safety in EVD placement.
Further development and application with other AR devices are promising for neurosurgical interventions.