A new tool for the navigated placement of intracerebral chemotherapy catheters.

Objective: The aim of this report is to illustrate a method for the precise placement of chemotherapeutic delivery catheters with the aid of computer-assisted navigation systems.

Materials and methods: We have developed a cannula which can be referenced to our navigation system (BrainLab (®)) to advance and position catheters. The cannula has a length of 10 cm. In the case of a ventricular puncture, CSF will drain through holes at the tip and a side port of the cannula to caution the surgeon. The cannula is fixed to the BrainLab (®) adapter ML and navigated with a BrainLab (®) vector vision (®) system. Using the puncture software, the placement is planned and executed. After placing the cannula as planned, the mandrin is removed and the primed catheter moved forward. When resistance is felt the cannula is withdrawn over the catheter. Further catheters can be placed similarly.

Results: Initial phantom tests showed a good target accuracy. Clinically we have used the cannula in 7 cases with good accuracy.

Conclusion: This newly designed tool is easy to handle and well integrated into the navigation system. It provides the means to place catheters precisely to the planned position. Potentially it can be combined with every navigation system using adaptable reference systems.