Technique, Results, and Complications Related to Robot-Assisted Stereoelectroencephalography

González-Martínez, Jorge; Bulacio, Juan; Thompson, Susan E.; Gale, John T.; Smithason, Saksith; Najm, Imad; Bingaman, William

doi:10.1227/neu.0000000000001034

Cited by 278 publications

(254 citation statements)

References 82 publications

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“…Thus, it can be expected that the absolute accuracy in future clinical trials will be degraded due to the above listed factors. This has already been confirmed by recent clinical case studies with the Neuromate [2] and ROSA [3], [16] robotic systems.…”

Section: Experimental Setup -Phantom Trialssupporting

confidence: 64%

A Novel Robotic Neuronavigation System: RONNA G3

Švaco

Šekoranja

Šuligoj

et al. 2017

SV-JME

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Section: Experimental Setup -Phantom Trialssupporting

confidence: 64%

A Novel Robotic Neuronavigation System: RONNA G3

Švaco

Šekoranja

Šuligoj

et al. 2017

SV-JME

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“…Recently, González-Martínez et al reported a median EPLE of 1.2 mm and TPLE of 1.7 mm (major bleeding: 1%) for 500 electrodes implanted at the Cleveland Clinic. 29 Moreover, the patient series by Cardinale accounted for 1050 electrodes implanted under assistance of a different robotic system and frame-based registration (EPLE: 0.78 mm, complications: 0%).…”

Section: Fig 5 A-cmentioning

confidence: 99%

Robot-assisted procedures in pediatric neurosurgery

Benedictis¹,

Trezza

Carai³

et al. 2017

Neurosurgical Focus

144

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OBJECTIVEDuring the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population.METHODSBetween 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging.RESULTSThe authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications.CONCLUSIONSTo the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical result, while minimizing postoperative morbidity.

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“…The cortical entry point is also the most important region for safety profiles. Gonzalez-Martinez et al 12 reported a median entry point LE of 1.2 mm (IQR 0.78-1.83 mm) from 500 electrodes implanted with the ROSA robot in frameless conditions.…”

Section: Accuracy In Clinical Studies For Seegmentioning

confidence: 99%

“…1,11,12,15,25 Patient registration can be performed in frame-based or frameless conditions. Since the fall of 2008, we have used a robotic assistant in frame-based conditions for implanting all SEEG electrodes at Niguarda Hospital.…”

mentioning

confidence: 99%

A new tool for touch-free patient registration for robot-assisted intracranial surgery: application accuracy from a phantom study and a retrospective surgical series

Cardinale¹,

Rizzi

d’Orio³

et al. 2017

Neurosurgical Focus

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OBJECTIVEThe purpose of this study was to compare the accuracy of Neurolocate frameless registration system and frame-based registration for robotic stereoelectroencephalography (SEEG).METHODSThe authors performed a 40-trajectory phantom laboratory study and a 127-trajectory retrospective analysis of a surgical series. The laboratory study was aimed at testing the noninferiority of the Neurolocate system. The analysis of the surgical series compared Neurolocate-based SEEG implantations with a frame-based historical control group.RESULTSThe mean localization errors (LE) ± standard deviations (SD) for Neurolocate-based and frame-based trajectories were 0.67 ± 0.29 mm and 0.76 ± 0.34 mm, respectively, in the phantom study (p = 0.35). The median entry point LE was 0.59 mm (interquartile range [IQR] 0.25–0.88 mm) for Neurolocate-registration–based trajectories and 0.78 mm (IQR 0.49–1.08 mm) for frame-registration–based trajectories (p = 0.00002) in the clinical study. The median target point LE was 1.49 mm (IQR 1.06–2.4 mm) for Neurolocate-registration–based trajectories and 1.77 mm (IQR 1.25–2.5 mm) for frame-registration–based trajectories in the clinical study. All the surgical procedures were successful and uneventful.CONCLUSIONSThe results of the phantom study demonstrate the noninferiority of Neurolocate frameless registration. The results of the retrospective surgical series analysis suggest that Neurolocate-based procedures can be more accurate than the frame-based ones. The safety profile of Neurolocate-based registration should be similar to that of frame-based registration. The Neurolocate system is comfortable, noninvasive, easy to use, and potentially faster than other registration devices.

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Technique, Results, and Complications Related to Robot-Assisted Stereoelectroencephalography

Abstract: The robotic SEEG technique and method were demonstrated to be safe, accurate, and efficient in anatomically defining the epileptogenic zone and subsequently promoting sustained seizure freedom status in patients with difficult-to-localize seizures.

Cited by 278 publications

References 82 publications

A Novel Robotic Neuronavigation System: RONNA G3

A Novel Robotic Neuronavigation System: RONNA G3

Robot-assisted procedures in pediatric neurosurgery

A new tool for touch-free patient registration for robot-assisted intracranial surgery: application accuracy from a phantom study and a retrospective surgical series

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