• Michael T Bounajem, Brandon Cameron, Kiel Sorensen, Ryan Parr, Wendell Gibby, Giyarpuram Prashant, James J Evans, and Michael Karsy.
• Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.
• Neurosurgery. 2023 Apr 1; 92 (4): 884891884-891.

BackgroundAugmented reality (AR) has demonstrated significant potential in neurosurgical cranial, spine, and teaching applications. External ventricular drain (EVD) placement remains a common procedure, but with error rates in targeting between 10% and 40%.ObjectiveTo evaluate Novarad VisAR guidance system for the placement of EVDs in phantom and cadaveric models.MethodsTwo synthetic ventricular phantom models and a third cadaver model underwent computerized tomography imaging and registration with the VisAR system (Novarad). Root mean square (RMS), angular error (γ), and Euclidian distance were measured by multiple methods for various standard EVD placements.ResultsComputerized tomography measurements on a phantom model (0.5-mm targets showed a mean Euclidean distance error of 1.20 ± 0.98 mm and γ of 1.25° ± 1.02°. Eight participants placed EVDs in lateral and occipital burr holes using VisAR in a second phantom anatomic ventricular model (mean RMS: 3.9 ± 1.8 mm, γ: 3.95° ± 1.78°). There were no statistically significant differences in accuracy for postgraduate year level, prior AR experience, prior EVD experience, or experience with video games ( P > .05). In comparing EVDs placed with anatomic landmarks vs VisAR navigation in a cadaver, VisAR demonstrated significantly better RMS and γ, 7.47 ± 0.94 mm and 7.12° ± 0.97°, respectively ( P ≤ .05).ConclusionThe novel VisAR AR system resulted in accurate placement of EVDs with a rapid learning curve, which may improve clinical treatment and patient safety. Future applications of VisAR can be expanded to other cranial procedures.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

18 keywords...

hide…