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Updated: Jul 10, 2026
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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Stereotactic Navigation and Intracranial Hemorrhage Risk Following Ventricular Catheter Placement: A Single-Center
Daniel N de Souza1,2, Spencer Frome1, Eric A Grin1
1Department of Neurosurgery, New York University Langone Health, New York, New York, USA.
Operative Neurosurgery (Hagerstown, Md.)
|July 9, 2026
Summary
Stereotactic navigation for cerebrospinal fluid shunt placement significantly reduces the risk of postoperative intracranial hemorrhage (ICH). This advanced technique offers improved safety outcomes for hydrocephalus treatment, with a number needed to treat of 34.
Area of Science:
- Neurosurgery
- Medical Technology
- Patient Safety
Background:
- Cerebrospinal fluid (CSF) shunting is a standard treatment for hydrocephalus.
- Limited comparative safety data exists for different ventricular catheter placement techniques.
- Evaluating novel techniques for improved patient outcomes is crucial.
Purpose of the Study:
- To assess if stereotactic navigation-assisted ventricular catheter placement reduces 30-day postoperative intracranial hemorrhage (ICH) rates.
- To compare the safety and efficacy of navigation-assisted versus non-navigation-assisted shunt placement.
- To analyze the impact of stereotactic navigation on hospital length of stay (LOS) and other complications.
Main Methods:
- Retrospective analysis of adult patients undergoing shunt placement for hydrocephalus (2014-2023).
- Primary exposure: use of stereotactic navigation for ventricular catheter placement.
- Primary outcomes: 30-day postoperative ICH and hospital LOS.
Main Results:
- Stereotactic navigation was used in 40.9% of 541 shunt placements.
- 30-day ICH rates were significantly lower with navigation (0.5% vs. 3.4%, P=.033).
- Navigation-assisted placement showed superior hemorrhage-free survival (log-rank P=.021) without increasing LOS or complications.
Conclusions:
- Stereotactic navigation-assisted ventricular catheter placement is associated with reduced 30-day postoperative ICH.
- The number needed to treat for ICH reduction was 34.
- Neuronavigation should be considered for shunt placement due to improved safety without adverse effects on other outcomes.
