Robot-guided Ventriculoperitoneal Shunt in Slit-like Ventricles

Area of Science:

• Neurosurgery
• Medical Robotics
• Hydrocephalus Management

Background:

• Ventriculoperitoneal shunt (VPS) is the primary treatment for hydrocephalus.
• Standard free-hand VPS placement is difficult in patients with small ventricles, leading to high failure rates.
• Stereotactic-guided VPS offers an alternative for challenging cases.

Purpose of the Study:

• To validate and describe the technique of robotic-guided VPS placement.
• To assess the efficacy of robotic guidance in patients with very small ventricles.

Main Methods:

• Three patients underwent robotic-guided VPS between 2016 and 2019.
• Pre-operative CT scans were used for surgical planning with the ROSA robotic system.
• Robotic arm followed a predetermined trajectory for shunt insertion.

Main Results:

• Successful ventricle access in a single attempt for all patients.
• Resolved CSF leak in the meningocele case.
• Improved headache and visual acuity in idiopathic intracranial hypertension cases.

Conclusions:

• Robotic-guidance is a safe and accurate method for VPS placement.
• This technique is particularly beneficial in cases with slit-like ventricles.