192 An Early Innovation Report of an Epidermal Ventriculoperitoneal (VP) Shunt Pressure Sensor. (28th February 2022)

• Record Type: Journal Article
• Authors: Ho, J.W.; Savvidis, P.; Ismail, M. A; Zonza, S.; Kamath, A.; Needham, A.; Carmona Sánchez, R.d.C.; Liao, H.; Teo, Mario.
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 1
• Publication Date: 2022-02-28
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac039.117
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Introduction: Ventriculoperitoneal shunt insertion, a common procedure for hydrocephalus, has a revision rate of approximately 20–30% within the first year, and continues to increase with each consecutive year. In Leeds, the average work-up cost for suspected shunt malfunctions was £765/patient. Additionally, patients with malfunctioning shunts present with vague symptoms potentially contributing to delayed presentation, especially important in Low-Middle Income Countries (LMICs) where neurosurgical expertise is less accessible. To reduce investigative costs and delayed presentations, we sought to design an epidermal shunt reservoir sensor to detect shunt malfunction by measuring the reservoir pressure. Method: Literature searches were conducted to identify a proof of concept and suitable materials to engineer a concept device based on a Failure Modes and Effects Analysis (FMEA) table with design specifications to assess relative clinical risks. Using the IDEAL-D Framework, we designed our low-fidelity prototype using Solidworks® software. Results: Literature revealed several devices aimed to detect shunt malfunctions. For our concept device, our focus was an accurate sensor and reliable connectivity. Our prototype uses gold nanowires to achieve high sensitivity to pressure change, as small as 15mPa. Near-field communication (NFC) for connectivity has less power requirement and has rapid connectivity compared to Bluetooth. Estimated cost of the device is £500. Conclusions: Our device, in Stage 0 of the IDEAL-D Framework, identified potential sensors and connectivity methods. We could utilise magnets to adhere to the reservoir with overlying hair. However, magnetic fields and atmospheric pressure could cause interference. Power source options still require exploring before benchtop testing for accuracy, interference, and feasibility.