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Updated: Nov 23, 2025

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Augmented reality-assisted ventriculostomy.

Max Schneider1, Christian Kunz2, Andrej Pal'a1

  • 11Department of Neurosurgery, University of Ulm, Günzburg; and.

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Summary
This summary is machine-generated.

This study introduces an augmented reality (AR) tool for neurosurgery, improving ventricular drain placement without rigid head fixation. The AR system demonstrated promising results in guiding surgeons, with potential for enhanced procedural accuracy and patient outcomes.

Keywords:
HoloLensHolomedaugmented realityventricular drainventricular punctureventriculostomy

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Area of Science:

  • Neurosurgery
  • Medical Technology
  • Augmented Reality

Background:

  • Ventricular drain placement is a common neurosurgical procedure.
  • Current freehand techniques desire improved success rates.
  • A need exists for advanced navigational tools that enhance surgical precision.

Purpose of the Study:

  • To develop a compact, augmented reality (AR)-based navigational tool for ventricular drain placement.
  • To enable surgeons to perform ventriculostomy without rigid patient head fixation.
  • To support surgeons during neurosurgical operations with real-time holographic guidance.

Main Methods:

  • Developed segmentation and tracking algorithms for AR guidance.
  • Utilized a Microsoft HoloLens AR headset with marker-based tracking for ventriculostomy guidance.
  • Conducted tests with 11 surgeons placing 110 external ventricular drains in a 3D-printed head model.
  • Assessed success rates and precision using CT scans.

Main Results:

  • The AR system demonstrated reliable performance in guiding ventriculostomy.
  • An overall ventriculostomy success rate of 68.2% was achieved.
  • The mean offset from the reference trajectory was 5.2 ± 2.6 mm, with improved precision in subsequent attempts.
  • Surgeons reported positive feedback, with most having prior AR experience.

Conclusions:

  • This represents the first report of marker-based, AR-guided ventriculostomy.
  • The initial results are encouraging for clinical implementation of this compact navigation device.
  • Further development of the marker system and hardware, along with addressing visuospatial issues, is planned prior to human application.