An Augmented Reality-Based Pre-Surgical Navigation System for Ventriculoperitoneal Shunt Placement: Development and Phantom Skull Assessment With Unity-Vuforia

Ventriculoperitoneal (VP) shunt placement is a vital technique for managing patients with hydrocephalus. However, the procedure encounters challenges due to the insufficient accuracy of anatomical landmarks and the high costs associated with advanced surgical navigation systems. To address these limitations, this study aims to assist in the pre-surgical planning phase of VP shunt placements using 3D-printed skulls. We developed the AR system using Unity and Vuforia to help surgeons visualise the trajectory of a catheter from an entry point on the skull to an intercept point in a ventricle. Experiments were conducted on one hundred commonly used freehand entry points across ten 3D-printed skulls to evaluate the accuracy of the intercept points generated by the AR system. The results indicate that the ventricle intercept points obtained through the system are on average 6 mm away from the ground truth, which falls within an acceptable range. This pilot study demonstrates the potential to enhance pre-surgical planning, particularly in resource-limited settings.