External Ventricular Drain Placement Teleproctoring Using a Novel Camera-Projector Navigation System: A Proof-of-Concept Study

Brandon D Philbrick; James Hu; Lily McCarthy; Ikaasa Suri; Jonathan T Dullea; Roshini Kalagara; Jhoneldrick Millares; Kurt A Yaeger

doi:10.1016/j.wneu.2023.03.001

External Ventricular Drain Placement Teleproctoring Using a Novel Camera-Projector Navigation System: A Proof-of-Concept Study

World Neurosurg. 2023 Jun:174:169-174. doi: 10.1016/j.wneu.2023.03.001. Epub 2023 Mar 7.

Authors

Brandon D Philbrick¹, James Hu², Lily McCarthy³, Ikaasa Suri³, Jonathan T Dullea³, Roshini Kalagara³, Jhoneldrick Millares², Kurt A Yaeger⁴

Affiliations

¹ Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: brandon.philbrick@mountsinai.org.
² Illuminant Surgical, Inc., Cambridge, Massachusetts, USA.
³ Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁴ Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

PMID: 36894005
DOI: 10.1016/j.wneu.2023.03.001

Abstract

Background: Teleproctoring is an emerging method of bedside clinical teaching; however, its feasibility has been limited by the available technologies. The use of novel tools that incorporate 3-dimensional environmental information and feedback might offer better bedside teaching options for neurosurgical procedures, including external ventricular drain placement.

Methods: A platform with a camera-projector system was used to proctor medical students on placing external ventricular drains on an anatomic model as a proof-of-concept study. Three-dimensional depth information of the model and surrounding environment was captured by the camera system and provided to the proctor who could provide projected annotations in a geometrically compensated manner onto the head model in real time. The medical students were randomized to identify Kocher's point on the anatomic model with or without the navigation system. The time required to identify Kocher's point and the accuracy were measured as a proxy for determining the effectiveness of the navigation proctoring system.

Results: Twenty students were enrolled in the present study. Those in the experimental group identified Kocher's point an average of 130 seconds faster than did the control group (P < 0.001). The mean diagonal distance from Kocher's point was 8.0 ± 4.29 mm for the experimental group compared with 23.6 ± 21.98 mm for the control group (P = 0.053). Of the 10 students randomized to the camera-projector system arm, 70% were accurate to within 1 cm of Kocher's point compared with 40% of the control arm (P > 0.05).

Conclusions: Camera-projector systems for bedside procedure proctoring and navigation are a viable and valuable technology. We demonstrated its viability for external ventricular drain placement as a proof-of-concept. However, the versatility of this technology indicates that that it could be useful for a variety of even more complex neurosurgical procedures.

Keywords: Bedside procedure; External ventricular drain; Medical education; Navigation; Proctoring.

Publication types

Randomized Controlled Trial

MeSH terms

Computer Simulation
Drainage* / methods
Humans
Neurosurgical Procedures* / methods