Novel Use of Augmented Reality-Guided Ventriculoperitoneal Shunt Proximal Catheter Placement Using the VisAR System: A Case Report

BACKGROUND AND IMPORTANCE: Ventriculoperitoneal (VP) shunt placement remains a standard treatment of hydrocephalus, yet the commonly used method of freehand proximal catheter placement is associated with high rates of malposition. Although stereotactic navigation increases accuracy, it can introduce workflow inefficiency and increase intraoperative complexity. Augmented reality (AR) is an emerging technology that provides real-time integration of 3-dimensional imaging directly onto the surgical field. This report aimed to describe the feasibility and technical nuances of AR-guided proximal catheter placement using the Novarad VisAR system during a VP shunt surgery. CLINICAL PRESENTATION: An eighty-one-year-old man with normal pressure hydrocephalus underwent elective VP shunt placement. CONCLUSION: Proximal catheter placement was successfully accomplished on first pass using AR guidance. Postoperative computed tomography head confirmed accurate placement consistent with preoperative planning. This case illustrates the first use of AR guidance for presurgical planning and intraoperative placement of a proximal ventricular catheter and demonstrates the feasibility of this technique.