This retrospective study evaluates the use of various guiding technologies in 309 neuroendoscopic interventions performed on 243 patients between 2016 and 2018. The study categorizes patients based on whether they received a new burr hole (group A) or had a preexisting one (group B), and assesses the application of coordinate-based (CB), guide-based (GB), ultrasound-assisted (UG), and augmented reality-navigated (NAR) techniques in these procedures. The majority of cases involved hydrocephalic conditions (81.6%). The overall complication rate was low at 4.5%. Based on the analysis, the study proposes a stratification system to select the most appropriate guiding technology for neuroendoscopic interventions, considering factors like surgical indication, fontanel status, entry point localization, preexisting burr hole, ventricular size, and target number. This tailored approach aims to reduce cost and time while maintaining safety and efficiency. The findings suggest the need for further research to validate the efficiency of this stratified decision-making algorithm.

Importance: This study introduces a stratified approach to selecting guiding technologies for neuroendoscopic procedures, potentially enhancing safety, efficiency, and cost-effectiveness.