The use of frameless navigation during endoscopic interventions in children with multilocular hydrocephalus

Abstract

INTRODUCTION: The use of the endoscopic technique largely improves treatment outcomes in patients with multilocular hydrocephalus. However, impaired anatomy and the lack of usual landmarks often cause problems in planning and intraoperative identification of changed structures. The use of frameless navigation during endoscopic interventions can significantly facilitate surgeon tasks and increases the efficacy of surgery. During surgery, the neuronavigation system visualizes a rigid endoscope that interconnects separated ventricles and cysts. Surgery can be completed with guiding a stent through an operating channel of the endoscope and implanting a shunt system. MATERIAL AND METHODS: Ten children underwent 11 endoscopic interventions using frameless intraoperative navigation at our clinic in 2013-2014. The number of surgically interconnected compartments ranged from 3 to 5. Simultaneous placement of a shunt system was performed in 8 of 11 interventions. RESULTS: Clinical improvement as a result of the operation was achieved in all children. 2 patients underwent re-operations 5 months and 1 year after endoscopic intervention. CONCLUSION: Thus, the use of frameless navigation during endoscopic interventions makes their implementation most efficient and safe for the patient.