• Jensen Ang, John J Y Zhang, Michael Yam, Tomasz Maszczyk, Wai Hoe Ng, and Kai Rui Wan.
• Department of Neurosurgery, National Neuroscience Institute, Singapore; Department of Neurosurgery, National Neuroscience Institute, Singapore General Hospital, Singapore. Electronic address: angwjj@gmail.com.
• World Neurosurg. 2023 Feb 1; 170: e777e783e777-e783.

BackgroundMispositioning of microelectrodes during deep brain stimulation surgery can incur serious complications for patients. Current practice of creating a burr hole for introduction of the microelectrode is done freehand and can cause trajectory misalignment. We aimed to create a sterilizable surgical adjunct to minimize error from burr hole placement.MethodsWe designed and demonstrated clinical use of a 3D-printed surgical jig that can be mounted to the current Cosman-Roberts-Wells stereotactic frame. The jig allowed accurate placement of the perforating burr for creation of the burr hole.ResultsIntraoperative usage of the jig in 11 patients who underwent bilateral deep brain stimulation microelectrode placement for Parkinson disease demonstrated high accuracy of microelectrode placement, with an average 1.18 mm deviation (range, 0-2.7 mm) from intended trajectories. No intraoperative complications were encountered.ConclusionsThis proof-of-concept study highlights the utility of 3D-printed surgical adjuncts that are fully customizable and rapidly produced to improve current surgical practice. The jig reduced surgery duration, need for multiple trajectories, and risk of potentially devastating neurological complications. As demonstrated, 3D-printed devices are useful as surgical adjuncts to optimize safety and efficacy in deep brain stimulation surgeries.Copyright © 2022 Elsevier Inc. All rights reserved.

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