# How we do it: Ultrasound-guided scuba technique for evacuation of intracerebral hematoma

## TL;DR

This paper describes a new ultrasound-guided technique for removing brain blood clots with minimal damage.

## Contribution

A novel 'Scuba' procedure using ultrasound and endoscopic guidance for intracerebral hematoma evacuation is introduced.

## Key findings

- Ultrasound provides real-time feedback during clot removal, improving surgical decisions.
- The Scuba technique uses a stereotactic canula and aspiration-debriding system under endoscopic view.
- The method requires specialized setup and training but may become a standard for brain surgeons.

## Abstract

Minimally invasive treatment of intracerebral hematomas is gaining importance following recent trials. Clot evacuation must minimise collateral damage while assuring optimal blood-volume reduction. Technical refinements call for systematic yet dynamic procedures, where ultrasound is an asset.

Description of the “Scuba” procedure and workflow: stereotactic canula insertion, clot evacuation with aspiration-debriding system under endoscopic view. Step-by-step ultrasound findings detailed.

ICH endoscopic evacuation may become a workhorse for cerebrovascular surgeons. Ultrasound provides real-time feedback on hematoma evacuation, becoming a reliable dynamic element in intraoperative decision-making. Yet, US requires a different operative setup and adds on to the learning curve.

The online version contains supplementary material available at 10.1007/s00701-025-06539-y.