{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T06:06:25Z","timestamp":1783922785226,"version":"3.55.0"},"reference-count":0,"publisher":"Armed Forces Medical Services","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosciences"],"abstract":"<jats:p>Objective: To compare the accuracy and clinical outcomes of proximal catheter placement using neuronavigation guidance versus the traditional free-hand technique in patients undergoing ventriculoperitoneal shunt (VPS) surgery. Methods: We performed a single-surgeon, before\u2013after cohort study: free-hand cases (2013\u20132019) and neuronavigation cases (2020\u20132024). Ethics approval was obtained (\u0130zmir Bak\u0131r\u00e7ay University; Approval No. 2407; 20 Aug 2025). The primary endpoint was a composite of first-attempt ventricular entry and absence of postoperative day-1 (POD1) Grade-3 malposition. Secondary endpoints included grades, 12-month proximal tip dysfunction, and operative duration. Results: Fifty-two patients were included (neuronavigation N = 24; free-hand N = 28). Composite success was 100% (24\/24) with neuronavigation versus 64.3% (18\/28) free-hand (RR 1.54, 95% CI 1.16\u20132.03; p = 0.00095), risk difference +35.7% (NNT\u2248 3). Grade-3 malposition occurred in 0% (0\/24) versus 32.1% (9\/28) (p = 0.002); Grades 1\u20132 (no Grade-3) were 100% versus 67.9% (RR 1.46, 95% CI 1.12\u20131.89). Optimal (Grade-1) placement was 70.8% versus 32.1% (RR 2.20, 95% CI 1.21\u20134.00; p = 0.0115). Twelve-month proximal tip dysfunction occurred in 8.3% versus 25.0% (RR 0.33, 95% CI 0.08\u20131.46). Operative time was longer with neuronavigation by +10.49 minutes (95% CI +7.40 to +13.58). Conclusion: In this before\u2013after, single-surgeon series, neuronavigation improved first-pass success and eliminated malposition, with an approximate 10-minute time penalty; multicenter confirmation is warranted. Given the retrospective, historically controlled design, residual confounding and time-related practice changes may persist; nonetheless, the magnitude of effect supports considering neuronavigation when resources and workflow allow in routine practice.<\/jats:p>","DOI":"10.17712\/1658-3183.2793","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T07:54:24Z","timestamp":1778918064000},"page":"164-173","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Free-Hand Technique and Neuronavigation in Intraventricular Shunt Catheter Placement"],"prefix":"10.17712","volume":"31","author":[{"given":"\u00dcmit","family":"Kocaman","sequence":"first","affiliation":[{"name":"\u0130zmir Bak\u0131r\u00e7ay University, School of Medicine, Neurosurgery Department, \u0130zmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durmu\u015f O","family":"Karakoyun","sequence":"additional","affiliation":[{"name":"\u0130zmir Bak\u0131r\u00e7ay University, School of Medicine, Neurosurgery Department, \u0130zmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"\u00c7avu\u015fo\u011flu","sequence":"additional","affiliation":[{"name":"\u00c7i\u011fli Educational and Research Hospital, Neurosurgery Department, \u0130zmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56029","published-online":{"date-parts":[[2026,4,30]]},"container-title":["Neurosciences"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T05:21:59Z","timestamp":1783920119000},"score":1,"resource":{"primary":{"URL":"https:\/\/nsj.researchcommons.org\/journal\/vol31\/iss2\/8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,30]]}},"URL":"https:\/\/doi.org\/10.17712\/1658-3183.2793","relation":{},"ISSN":["1658-3183"],"issn-type":[{"value":"1658-3183","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]}}}