Real-time three-dimensional robotic C-arm navigation for ventriculoperitoneal shunt placement: a single-center retrospective study.

OBJECTIVE

To evaluate the accuracy, safety, and clinical outcomes of ventriculoperitoneal (VP) shunt placement using real-time three-dimensional (3D) robotic C-arm navigation in adults with hydrocephalus.

METHODS

A retrospective review was conducted on 82 patients who underwent VP shunt placement in a hybrid operating room between September 2018 and December 2022. All procedures utilized intraoperative 3D robotic C-arm navigation for ventricular catheter placement. Data included demographics, operative details, postoperative imaging, and complications. Catheter tip position was graded, and patients were followed for at least three years.

RESULTS

First-pass ventricular access was achieved in all cases. Optimal tip positioning (Grade 1) was observed in 79% of patients, Grade 2 in 20%, and Grade 3 in 1%. The mean operative time was 76.6 ± 20.6 min. Postoperative complications occurred in 7% of patients, primarily related to distal catheter issues; no cerebrospinal fluid-side revisions were required during follow-up.

CONCLUSION

Real-time 3D robotic C-arm navigation enables precise ventricular catheter placement with high first-pass success, and low complication rates. This technique may reduce mechanical shunt failure and warrants prospective comparative studies to confirm its benefits and cost-effectiveness.