Virtual and augmented reality in ventriculostomy: A systematic review

Background Ventriculostomy, one of the most common neurosurgical procedures, involves inserting a draining catheter into the brain’s ventricular system to alleviate excessive cerebrospinal fluid (CSF) accumulation. Tradition- ally, this procedure has relied on freehand techniques guided by anatomical landmarks, which have shown a high rate of misplacement. Recent advancements in virtual reality (VR) and augmented reality (AR) technologies have opened up new possibilities in the field. This comprehensive review aims to analyze the existing literature, examine the diverse applications of VR and AR in ventriculostomy procedures, address their limitations, and propose potential future directions. Methods A systematic search was conducted in Web of Science and PubMed databases to identify studies employ- ing VR and AR technologies in ventriculostomy procedures. Review papers, non-English records, studies unrelated to VR/AR technologies in ventriculostomy, and supplementary documents were excluded. In total 29 papers were included in the review. Results The development of various VR and AR systems aimed at enhancing the ventriculostomy procedure are categorized according to the Data, Visualization and View (DVV) taxonomy. The study investigates the data utilized by these systems, the visualizations employed, and the virtual or augmented environments created. Furthermore, the surgical scenarios and applications of each method, as well as the validation and evaluation metrics used, are discussed. Discussion The review delves into the fundamental challenges encountered in the implementation of VR and AR systems in ventriculostomy. Additionally, potential future directions and areas for improvement are proposed, addressing the identified limitations and paving the way for further advancements in the field.