Minimally Invasive Intracerebral Hemorrhage Evacuation: A review

Musa, Mishek; Carpenter, Austin B.; Kellner, Christopher P.; Sigounas, Dimitri; Godage, Isuru S.; Sengupta, Saikat; Oluigbo, Chima; Cleary, Kevin; Chen, Yue

doi:10.1007/s10439-022-02934-z

Cited by 8 publications

(6 citation statements)

References 71 publications

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“…The frontal lobe approach can improve the clearance rate of hematoma and improve cerebral blood circulation. [19,20] This study also found that the frontal lobe group had a higher rate of good prognosis than the temporal lobe group did. This indicates that the endoscopy-assisted frontal lobe approach can effectively promote good outcomes in patients with HICH.…”

Section: Discussionsupporting

confidence: 54%

“…Main reason: When using the temporal approach to remove an intracerebral hematoma, it is easy to limit the direct viewing angle because of the consistency between the line of sight and the length of the hematoma, thereby reducing the hematoma clearance rate. [ 20 , 21 ] Even by adjusting the direction of neuroendoscopy and using angled neuroendoscopy to increase the visual range, the location of the hematoma can increase brain tissue damage, which is not conducive to disease progression, and the temporal approach is prone to transverse damage to the conduction tract. The line of sight and length of the hematoma in the frontal lobe approach are basically consistent and roughly parallel to the conduction tract, which provides better protection for the conduction tract than the temporal approach, improves neurological function, and ensures the effectiveness of disease prognosis.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of therapeutic effects of endoscopic assisted different surgical approaches in hypertensive intracerebral hemorrhage: A retrospective cohort study

Wang,

Su,

Zhou

et al. 2024

Medicine

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We aimed to explore the therapeutic effects of endoscopically assisted surgical approaches for HICH. In this retrospective cohort study, we retrospectively analyzed the treatment status of 118 patients with HICH who underwent surgery for hematoma removal. Among them, 61 patients underwent endoscopically assisted hematoma removal surgery through the frontal lobe approach (frontal lobe group); 57 patients underwent endoscopic hematoma assisted via the temporal lobe approach (temporal lobe group). Treatment effects, cerebral hemodynamic status before and after treatment, postoperative prognosis at one month, and incidence of complications were compared between the 2 groups. We found that the total effective treatment rate in the frontal lobe group was higher than that in the temporal lobe group (P < .05). After surgery, the R during the contraction period of the common cerebral artery in both groups decreased compared to that before surgery, and the frontal lobe group was significantly lower than the temporal lobe group; the V and Q were higher than those before surgery, and the frontal lobe group was significantly higher than the temporal lobe group (P < .05). The prognosis of the frontal lobe group was better than that of the temporal lobe group (P < .05). Compared to the endoscopic-assisted temporal approach, the endoscopic-assisted frontal lobe approach for the treatment of HICH can improve cerebral hemodynamic status, enhance treatment efficacy, and improve prognosis.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Comparison of therapeutic effects of endoscopic assisted different surgical approaches in hypertensive intracerebral hemorrhage: A retrospective cohort study

Wang,

Su,

Zhou

et al. 2024

Medicine

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“…1 ) (Table 1 ), including ROSA ® (Zimmer Biomet, Warsaw, Indiana, USA), Remebot ® (Remebot Technology Co., Beijing, China), and CAS-R-2 frameless stereotactic system (HOZ Medical Co, Beijing, China), have undergone preliminary validation through small-scale clinical trials for the treatment of ICH. These robots are all commercially available robotic, which employ robotic arms with multiple degrees of freedom to achieve accurate position and integrate the functions of surgical path planning, navigation and control software [ 14 ]. The related clinical researches have showed that robotic-assisted surgery for ICH is safe and efficient [ 15 – 20 ].…”

Section: Current Status Of Surgical Robots For Ichmentioning

confidence: 99%

“…During MIS for ICH, the puncture needle needs to pass through three types of tissues of different stiffnesses, including the skull (solid, rigid), brain tissue (semisolid, flexible) and hematoma (liquid, soft), the stiffness of which can differ by orders of magnitude [ 34 – 36 ]. Frameless stereotactic robots insert puncture instruments into specific targets through straight-line trajectories within the brain, while the mainstream brain puncture needles in clinical practice are straight and rigid, posing a challenge to the avoidance of critical anatomical structures and the efficacy of hematoma evacuation, especially when hematoma is deep or irregular in shape [ 14 ]. Continuous robots, particularly concentric tube robots, are capable of nonlinear motion, which provides a promising alternative for MIS [ 37 ].…”

Section: Puncture Instrumentmentioning

confidence: 99%

Surgical Robotics for Intracerebral Hemorrhage Treatment: State of the Art and Future Directions

Chen

Pan

et al. 2023

Ann Biomed Eng

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Intracerebral hemorrhage (ICH) is a stroke subtype with high mortality and disability, and there are no proven medical treatments that can improve the functional outcome of ICH patients. Robot-assisted neurosurgery is a significant advancement in the development of minimally invasive surgery for ICH. This review encompasses the latest advances and future directions of surgical robots for ICH. First, three robotic systems for neurosurgery applied to ICH are illustrated. Second, the key technologies of robot-assisted surgery for ICH are introduced in aspects of stereotactic technique and navigation, the puncture instrument, and hematoma evacuation. Finally, the limitations of current surgical robots are summarized, and the possible development direction is discussed, which is named “multisensor fusion and intelligent aspiration control of minimally invasive surgical robot for ICH”. It is expected that the new generation of surgical robots for ICH will facilitate quantitative, precise, individualized, standardized treatment strategies for ICH.

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“…13 Robotics has the potential to improve ICH or stroke treatment. 14 Our team developed a novel MRIcompatible concentric tube robotic aspiration device for ICH evacuation. The concentric tube mechanism consists of a straight outer tube and a J-shaped inner aspiration cannula that is elastic to access large hematomas when deployed.…”

Section: Introductionmentioning

confidence: 99%

MRI-compatible robot for intracerebral hemorrhage evacuation: sheep brain phantom study

Nanziri,

Lam,

Yarmolenko

et al. 2024

Medical Imaging 2024: Image-Guided Procedures, Robotic Interventions, and Modeling

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An MRI-Compatible robotic aspiration device has been developed with the goal of improving minimally invasive treatment for intracerebral hemorrhage (ICH). Current minimally invasive approaches have demonstrated promising clinical outcomes in preliminary trials when compared to conservative treatment or surgery. However, these approaches do not allow for hemorrhage evacuation while monitoring for evacuation progress and brain tissue involvement under MRI.The robotic aspiration device has a concentric tube mechanism which consists of a straight outer tube and an elastic inner aspiration cannula to allow for access to hematomas when deployed. We started evaluating the robot in MRI-guided human brain phantom studies. As a next step, we assessed the workflow of the robot system in an MRI-guided sheep brain phantom study. The phantom was created using Humimic Medical gel that was melted and poured into a 3D-printed sheep brain model. The gel was left to solidify, and a cavity was created for a clot. The measured clot volume prior to evacuation was 9.04mL. The robot was advanced into the clot and aspiration was performed with real-time intraoperative MR imaging. The volume of clot was reduced by 83% and the phantom did not have any unexpected damage when it was physically analyzed after the procedure.Our long-term goal is to develop a safe MRI-compatible minimally invasive robotic procedure for ICH evacuation. We are currently preparing for live sheep animal studies.

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Minimally Invasive Intracerebral Hemorrhage Evacuation: A review

Cited by 8 publications

References 71 publications

Comparison of therapeutic effects of endoscopic assisted different surgical approaches in hypertensive intracerebral hemorrhage: A retrospective cohort study

Comparison of therapeutic effects of endoscopic assisted different surgical approaches in hypertensive intracerebral hemorrhage: A retrospective cohort study

Surgical Robotics for Intracerebral Hemorrhage Treatment: State of the Art and Future Directions

MRI-compatible robot for intracerebral hemorrhage evacuation: sheep brain phantom study

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