The Clinical Application of Robot-Assisted Ventriculoperitoneal Shunting in the Treatment of Hydrocephalus.

De-Feng Liu,Fan-Gang Meng,Huan-Guang Liu,Jian-Guo Zhang,An-Chao Yang,Kai Zhang

doi:10.3389/fnins.2021.685142

Abstract

BackgroundThis work aims to assess the effectiveness and safety of robotic assistance in ventriculoperitoneal shunting and to compare the results with data from traditional surgery.MethodsWe retrospectively analyzed 60 patients who had undergone ventriculoperitoneal shunting, of which shunts were implanted using a robot in 20 patients and using traditional surgical methods in the other 40 patients. Data related to surgery were compared between the two groups, and the accuracy of the drainage tube in the robot-assisted group was assessed.ResultsIn the robot-assisted surgery group, the operation duration was 29.75 ± 6.38 min, intraoperative blood loss was 10.0 ± 3.98 ml, the success rate of a single puncture was 100%, and the bone hole diameter was 4.0 ± 0.3 mm. On the other hand, the operation duration was 48.63 ± 6.60 min, intraoperative blood loss was 22.25 ± 4.52 ml, the success rate of a single puncture was 77.5%, and the bone hole diameter was 11.0 ± 0.2 mm in the traditional surgery group. The above are statistically different between the two groups (P < 0.05). Only one case of surgery-related complications occurred in the robot-assisted group, while 13 cases occurred in the traditional surgery group. There was no significant difference in the hospitalization time. In the robot-assisted surgery group, the average radial error was 2.4 ± 1.5 mm and the average axial error was 1.9 ± 2.1 mm.ConclusionIn summary, robot-assisted implantation is accurate, simple to operate, and practical; the duration of surgery is short; trauma to the patient is reduced; and fewer postoperative complications related to surgery are reported.

Highlights

Hydrocephalus is common in all types of craniocerebral trauma and in the case of an intracranial mass, which leads to the progressive dilatation of the ventricular system and/or subarachnoid space due to the disturbance of absorption, circulation, or excessive secretion of cerebrospinal fluid
The drainage tube is connected to a shunt valve, the abdominal cavity-end drainage tube is placed under the skin into the abdominal cavity through a tunnel
The precise placement of the drainage tube in traditional surgery is vital, but it is difficult to control the position and length of the drainage tube in the ventricle due to the different sizes of the ventricles of each patient. Various complications such as incorrect placement, infection, bleeding, and obstruction of the shunt system may occur after traditional ventriculoperitoneal shunt (VPS) surgery, which leads to poor surgical results

Summary

Introduction

Hydrocephalus is common in all types of craniocerebral trauma and in the case of an intracranial mass, which leads to the progressive dilatation of the ventricular system and/or subarachnoid space due to the disturbance of absorption, circulation, or excessive secretion of cerebrospinal fluid. VPS involves the insertion of a ventricle-end drainage tube into the ventricle through a skull drill. The precise placement of the drainage tube in traditional surgery is vital, but it is difficult to control the position and length of the drainage tube in the ventricle due to the different sizes of the ventricles of each patient. Various complications such as incorrect placement, infection, bleeding, and obstruction of the shunt system may occur after traditional VPS surgery, which leads to poor surgical results. This work aims to assess the effectiveness and safety of robotic assistance in ventriculoperitoneal shunting and to compare the results with data from traditional surgery

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