Proposed Simple, Efficient Free Hand Technique for Frontal External Ventricular Drain (EVD) in Case of Small Ventricle: A Report of New Technique

作     者：Fawaz Eljili Marhoom Abdelradi Emad Ibrahim Ahmed Fawaz Eljili Marhoom Abdelradi;Emad Ibrahim Ahmed

作者机构：Royal Care International Hospital Khartoum Sudan Faculty of Medicine Sudan University of Science and Technology Khartoum Sudan 

出 版 物：《Open Journal of Modern Neurosurgery》 (现代神经外科学进展（英文）)

年 卷 期：2023年第13卷第3期

页      面：121-128页

学科分类：0809[工学-电子科学与技术（可授工学、理学学位）] 08[工学] 

主　　题：Frontal Ventriculostomy Freehand EVD Small Ventricle EVD Frontal Horn EVD 

摘      要：Background: EVD is a common procedure done in neurosurgery and the residents should master it and this is what exactly means that it should be simple, safe, fast and accurate. EVD can be done through many entry points to the different part of the lateral ventricle but the famous site is the anterior horn of the lateral ventricle which is commonly approached through Kocher’s point which is a famous point for all neurosurgeon by its measurements of allocation. The commonest problem with EVD insertion into the anterior horn is the navigation of the ventricular cavity with the right trajectory and so the location of the catheter tip in the right place near the foramen of monro to ensure CSF draining. Size of the ventricle plays significant role in the success of the procedure especially free hand technique. The more dilated ventricle, the more chance to hit the ventricular cavity especially from the first trial and vice versa. In case of small ventricle, the procedure with free hand technique seems more complicated and the chance to hit the ventricle from the first trial may reduce especially with non-expert surgeon but may succeed in the following trials with increased risk of complications with more trials. Purpose: Most EVD’s are placed with freehand technique which depends on the operator skills to navigate the ventricle with right trajectory and hit the ventricle from the first trial, because many trials may complicate the procedure and produce undesirable side effects. So the key in this free hand technique is how to ensure the success from the first trial. In case of small anterior horn of the lateral ventricle, the procedure is even more difficult with the free hand technique and the classic Kocher point needs an expert to get the right trajectory to navigate such small ventricle. Our point idea came from this prospective and aimed at raising the success of the procedure especially in the first attempt with simple technique. Method: It is a new entry point for E