Computer Assist Laser Frame To Guide Lateral Ventricular Frontal Horn Puncture

Background and Objectives: Ventriculopuncture,a Basic operation of neurosurgery,is often used for decompression of severe intracranial hypertension,drainage of inflammatory cerebrospinal fluid,puncture and drainage of ventricular hemorrhage,ventricleperitoneal shunt and intracranial pressure monitoring.Neurosurgeons usually adopt traditional methods to locate and puncture according to patient imaging data,such as CT,MRI,etc..But them need to adjust puncture direction based on the traditional methods in some special cases,such as ventricular displacement,deformation,etc..The commonly methods of ventriculopuncture has lateral ventricular frontal horn puncture and occipital horn puncture,there are also inferior horn puncture and temporal horn puncture etc..Lateral ventricular frontal horn puncture is often used as the preferred method by neurosurgeons because of forehead without choroid plexus is large,and lateral ventricular frontal horn puncture is less in postoperative complications.There are various methods of lateral ventricular frontal horn puncture with high success rate success rate that are accepted by most neurosurgeons.But there are still some unsuccessful cases such as failure in puncture,the drainage tube is not in good position or even damage important nerve due to the special ventricular structure and lack of experience etc..This not only brings physical and economic damage to the patient,but also causes waste of medical resources.Although there are a variety of high-tech and accurate positioning devices,them cannot be popularized because of its high cost and complicated operation.Therefore,this study designed a new,simple and effective method of lateral ventricular frontal horn puncture based on the traditional methods to improve maneuverability and success rate of lateral ventricular frontal horn puncture.Materials and Methods: 1.Laser assisted puncture frame: It is formed by a "bow" shaped metal frame,it can emit laser light plane,and leads the reference line marking surface.2.Laser model: To create three mutually perpendicular plane model by mimics.3.Simulated surgery: Acquiring CT data of the patient head,introducing mimics17,then the ventricle,skull and skin three-dimensional model were synthesized.The laser plane model is imported into the software to match with the skull model,and the puncture is simulated on the computer,and record the corresponding parameters.4.Select the patient In our department from February 2017 to February 2018,30 patients who underwent ventricular puncture were enrolled in the study.Eleven patients underwent computer-aided infrared frame guided puncture and 19 patients underwent traditional puncture.5.Surgery Computer simulations to complete surgery,and record the appropriate parameters.After the anesthesia is safe,the laser frame is placed on the head of the patient and the angle of the laser light is adjusted according to the parameters of the simulated operation.The marker pen marks the projection line of laser light on the body surface.Conventional disinfection,incision,drilling,puncture needle along the intersection of the two planes into the needle,puncture depth with the depth of the simulation surgery.to give symptomatic treatment according to the patient's specific condition after surgery.Result: Table.1 Comparison of two groups of resultsConclusion: Using computer-aided laser frame to guide the LVFH puncture can improve the success rate of puncture,reduce the number of punctures,less risk of brain damage and bleeding,and the operation is simple and effective,suitable for universal.