Efficacy Analysis of Robot-Assisted Minimally Invasive Surgery for Small-Volume Spontaneous Thalamic Hemorrhage

Wang, Yu; Jin, Hai; Gong, Shusheng; Yang, Xiaotao; Sun, Xiao; Xu, Mengting; Yang, Liu; Wang, Shimiao; Song, Weilong; Tao, Yingqun

doi:10.1016/j.wneu.2019.07.224

Cited by 13 publications

(5 citation statements)

References 13 publications

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“…During the phase of the preoperative projection, we usually reconstruct the three-dimensional morphology of the hematoma to design an individualized surgical projection. With image fusion of CTA, all visible blood vessels and sulci following the path can be avoided as much as possible to reduce vascular damage, which is of paramount importance for minimally invasive surgery ( 24 , 33 ). At the registration stage, we usually adopt the minimum registration error method of bone markers to ensure the maximum accuracy of puncture.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, minimally invasive stereotactic surgery has been applied for brainstem hemorrhage surgery, with encouraging results since 1989 ( 6 , 17 , 22 , 23 ). As an accurate auxiliary tool for surgical location, the robot stereotactic system is used in intracerebral hematoma puncture in addition to stereoelectroencephalogra-phy (SEEG) implantation and deep-brain stimulation (DBS) ( 24–26 ). Compared with frame-based stereotactic procedures, robot-assisted technology can reach some targets that frame-based stereotactic surgery cannot, reduce the operation time and prevent the pain caused by installing the frame ( 27 ).…”

Section: Introductionmentioning

confidence: 99%

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Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage

Tang,

Huang,

Chen

et al. 2024

Front. Neurol.

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ObjectiveSpontaneous hypertensive brainstem hemorrhage (HBSH) is characterized by sudden onset, rapid progression and poor prognosis. There has been a growing tendency of surgical treatment for HBSH. This study aimed to investigate outcomes and potential factors associated with the prognosis of robot-assisted drainage surgery for HBSH treatment.MethodsPatients with HBSH from July 2016 to March 2023 at a single neurosurgery center were included and divided into conservative group and surgical groups. Baseline and clinical data, radiographic characteristics, complications, and outcome evaluations were recorded and analyzed.ResultsA total of 125 patients, with 74 in the conservative group and 51 in the surgical group, were enrolled in the study. Mortality at 6 months was 59/74 (79.7%) in the conservative group and 9/51 (17.6%) in the surgical group. Twenty-four patients (47.1%) achieved favorable outcomes in the surgical group, whereas this rate in the conservative group was only 5.4% (4/74). There was a significant difference in NIHSS, GCS, and mRS at 6 months between surviving patients in the conservative and surgical groups. In prognostic analysis in the surgical subgroup, initial GCS score [5 (IQR 4–7) vs. 3 (IQR 3–4), p < 0.001], NIHSS [36 (IQR 32–38) vs. 40 (IQR 38–40), p < 0.001], smoking history [45.8% (11/24) vs. 74.1% (20/27), p = 0.039], hematoma volume [6.9 (IQR 6.2–7.6) vs. 9.6 (IQR 7.3–11.4), p = 0.001], and hemorrhage location (p = 0.001) were potential risk factors for poor 6-month prognosis after robot-assisted surgery for HBSH.ConclusionBased on the results of this study, robot-assisted minimally invasive drainage of brain stem hematoma may significantly reduce mortality and improve prognosis. Surgery should be conducted for selected patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage

Tang,

Huang,

Chen

et al. 2024

Front. Neurol.

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“…MISPT is associated with less brain tissue injury, less bleeding, milder cerebral edema, shorter operation time and hospital stay, and faster recovery (Li et al., 2017 ). Frame‐assisted MISPT is particularly suitable for the removal of deep hematomas and elderly and infirm patients who cannot tolerate craniotomy because of its less invasive nature (Matsumoto & Hondo, 1984 ; Wang et al., 2019 ). However, preoperative preparations for frame‐assisted MISPT are complex and time‐consuming; moreover, it is associated with a relatively high infection rate, does not avoid blood vessels, and is associated with a high incidence of rebleeding (Xiao et al., 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of robot‐assisted minimally invasive stereotactic puncture therapy for supratentorial hypertensive intracerebral hemorrhage

Han,

Xie,

Chen

et al. 2024

Brain and Behavior

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ObjectiveTo evaluate the efficacy of robot‐assisted minimally invasive stereotactic puncture therapy (MISPT) for supratentorial hypertensive intracerebral hemorrhage (HICH).MethodsWe retrospectively analyzed 133 patients with supratentorial HICH treated using robot‐assisted MISPT (RM group; n = 77) or conventional craniotomy (CC group; n = 56). In our primary analysis, we evaluated the hematoma volume at discharge. In our secondary analyses, we evaluated the Glasgow Coma Scale (GCS) score at discharge; the operation time, intraparenchymal drainage catheter removal time, the length of hospital stay, and complications during hospitalization; the early and 6‐month postoperative mortality; and functional scores 6‐month postoperatively.ResultsThere were no statistical differences in the preoperative characteristics between the groups, such as age distribution (52.8 ± 9.6 vs. 55.3 ± 7.8 years), hematoma volume (38.4 ± 10.4 vs. 41.1 ± 11.0 mL), and GCS score (10.7 ± 2.2 vs. 9.8 ± 2.8). Hematoma volume at discharge did not significantly differ between the groups (2.6 ± 2.1 mL vs. 2.4 ± 2.1 mL). The GCS score at discharge was significantly higher in the RM group (13.5 ± 2.1 vs. 11.6 ± 3.1; p < .001). Operation time (40.3 ± 7.0 min vs. 143.1 ± 61.3 min;p < .001), intraparenchymal drainage catheter removal time (1.2 ± 0.4 vs. 2.1 ± 0.7 days; p < .001), and length of hospital stay (9.3 ± 2.7 vs. 11.1 ± 4.8 days; p = .013) were significantly shorter in the RM group. The incidence rates of pneumonia, gastrointestinal bleeding, and intracranial infection were significantly lower in the RM group. Although the incidence of rebleeding was lower in the RM group (1.3% vs. 5.4%), the difference was not significant. Six months after surgery, the Barthel Index, Glasgow Outcome Scale, and Karnofsky performance status scores were significantly higher, whereas the modified Rankin scale score was significantly lower in the RM group (p = .002, p = .007, p = .001, and p = .018, respectively). Two RM group patients (3.1%) and six CC group patients (12.2%) died between hospital discharge and 6 months after surgery (p = .127).ConclusionThe main advantages of robot‐assisted MISPT for supratentorial HICH were shown in minimally invasive, precision, and low incidences of complications. In addition, it may improve the prognosis significantly. Thus, it has great potential to be popularized and clinically applied in the future.

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“…These attributes provide for a safer and more reliable and accurate technique compared with traditional operations. To date, neurosurgery robots have mainly been in involved in DBS, SEEG, and SBB; stereotactic needle aspiration from hematoma, cysts, and abscesses; brachytherapy; and thermal ablation of brain tumors and seizure-generating regions (De Benedictis et al, 2017;MacDonell et al, 2018;Minchev et al, 2019;Wang Y. et al, 2019;Chaitanya et al, 2020;Moran et al, 2020). This novel robotassisted operative technique results in millimeter accuracy in drainage tube placement.…”

Section: Discussionmentioning

confidence: 99%

Clinical Application of a Neurosurgical Robot in Intracranial Ommaya Reservoir Implantation

Liu

Zhang

et al. 2021

Front. Neurorobot.

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Background: The Ommaya reservoir implantation technique allows for bypass of the blood-brain barrier. It can be continuously administered locally and be used to repeatedly flush the intracranial cavity to achieve the purpose of treatment. Accurate, fast, and minimally invasive placement of the drainage tube is essential during the Ommaya reservoir implantation technique, which can be achieved with the assistance of robots.Methods: We retrospectively analyzed a total of 100 patients undergoing Ommaya reservoir implantation, of which 50 were implanted using a robot, and the remaining 50 were implanted using conventional surgical methods. We then compared the data related to surgery between the two groups and calculated the accuracy of the drainage tube of the robot-assisted group.Results: The average operation time of robot-assisted surgery groups was 41.17 ± 11.09 min, the bone hole diameter was 4.1 ± 0.5 mm, the intraoperative blood loss was 11.1 ± 3.08 ml, and the average hospitalization time was 3.9 ± 1.2 days. All of the Ommaya reservoirs were successful in one pass, and there were no complications such as infection or incorrect placement of the tube. In the conventional Ommaya reservoir implantation group, the average operation time was 65 ± 14.32 min, the bone hole diameter was 11.3 ± 0.3 mm, the intraoperative blood loss was 19.9 ± 3.98 ml, and the average hospitalization time was 4.1 ± 0.5 days. In the robot-assisted surgery group, the radial error was 2.14 ± 0.99 mm and the axial error was 1.69 ± 1.24 mm.Conclusions: Robot-assisted stereotactic Ommaya reservoir implantation is quick, effective, and minimally invasive. The technique effectively negates the inefficiencies of craniotomy and provides a novel treatment for intracranial lesions.

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Efficacy Analysis of Robot-Assisted Minimally Invasive Surgery for Small-Volume Spontaneous Thalamic Hemorrhage

Cited by 13 publications

References 13 publications

Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage

Curative effect analysis of robot-assisted drainage surgery in treatment of spontaneous hypertensive brainstem hemorrhage

Efficacy of robot‐assisted minimally invasive stereotactic puncture therapy for supratentorial hypertensive intracerebral hemorrhage

Clinical Application of a Neurosurgical Robot in Intracranial Ommaya Reservoir Implantation

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