Accuracy of Robotic and Frame-Based Stereotactic Neurosurgery in a Phantom Model

Spyrantis, Andrea; Woebbecke, Tirza; Rueß, Daniel; Constantinescu, Anne; Gierich, Andreas; Luyken, Klaus; Visser‐Vandewalle, Veerle; Herrmann, Eva; Geßler, Florian; Czabanka, Marcus; Treuer, Harald; Ruge, Maximilian I.; Freiman, Thomas M.

doi:10.3389/fnbot.2022.762317

Cited by 4 publications

(3 citation statements)

References 25 publications

(36 reference statements)

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“…Modern stereotactic neurosurgery commonly uses surgical robots which have further improved accuracy and efficiency when compared with traditional frame-based methods. [37][38][39][40] Fig. 1 Intraoperative photo of an anatomical hemispherectomy for a patient with Rasmussen's syndrome.…”

Section: Stereotaxymentioning

confidence: 99%

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Minimally Invasive Destructive, Ablative, and Disconnective Epilepsy Surgery

Treiber

Bayley

Curry

2023

Journal of Pediatric Epilepsy

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Conventional epilepsy surgery performed by microsurgical dissection typically requires large cranial working windows created with high-speed drills and lengthy incisions. In the past few decades, minimally invasive techniques have been developed with smaller incisions, comparable efficacy, shorter hospitalizations, and better safety profiles. These minimally invasive alternatives utilize stereotactic, ultrasonic, radiotherapeutic, and endoscopic techniques. Although not able to completely replace conventional surgery for all etiologies of epilepsy, these minimally invasive techniques have revolutionized modern epilepsy surgery and have been an invaluable asset to the neurosurgeon's repertoire. The endoscope has allowed for surgeons to have adequate visualization during resective and disconnective epilepsy surgeries using keyhole or miniature craniotomies. Modern stereotactic techniques such as laser interstitial thermal therapy and radiofrequency ablation can be used as viable alternatives for mesial temporal lobe epilepsy and can destroy lesional tissue deep areas without the approach-related morbidity of microsurgery such as with hypothalamic hamartomas. These stereotactic techniques do not preclude future surgery in the settings of treatment failure and have been used successfully after failed conventional surgery. Multiple ablation corridors can be performed in a single procedure that can be used for lesioning of large targets or to simplify treating multifocal epilepsies. These stereotactic techniques have even been used successfully to perform disconnective procedures such as hemispherotomies and corpus callosotomies. In patients unable to tolerate surgery, stereotactic radiosurgery is a minimally invasive option that can result in improved seizure control with minimal procedural risks. Advances in minimally invasive neurosurgery provide viable treatment options for drug-resistant epilepsy with quicker recovery, less injury to functional brain, and for patients that may otherwise not choose conventional surgery.

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Section: Stereotaxymentioning

confidence: 99%

“…Modern stereotactic neurosurgery commonly uses surgical robots which have further improved accuracy and efficiency when compared with traditional frame-based methods. 37 38 39 40…”

Section: Minimally Invasive Neurosurgerymentioning

confidence: 99%

Minimally Invasive Destructive, Ablative, and Disconnective Epilepsy Surgery

Treiber

Bayley

Curry

2023

Journal of Pediatric Epilepsy

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“…Based on the same idea as in the previous study, Spyrantis et al proposed an experimental phantom study to compare the mechanical accuracy of the ROSA robot and the Leksell stereotactic frame [ 58 ]. Fifty trajectories were analyzed for each method.…”

Section: Innovations To Improve Perioperative Workflowmentioning

confidence: 99%

Advances, technological innovations, and future prospects in stereotactic brain biopsies

Bex

Mathon

2022

Neurosurg Rev

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Stereotactic brain biopsy is one of the most frequently performed brain surgeries. This review aimed to expose the latest cutting-edge and updated technologies and innovations available to neurosurgeons to safely perform stereotactic brain biopsy by minimizing the risks of complications and ensuring that the procedure is successful, leading to a histological diagnosis. We also examined methods for improving preoperative, intraoperative, and postoperative workflows. We performed a comprehensive state-of-the-art literature review. Intraoperative histology, fluorescence, and imaging techniques appear as smart tools to improve the diagnostic yield of biopsy. Constant innovations such as optical methods and augmented reality are also being made to increase patient safety. Robotics and integrated imaging techniques provide an enhanced intraoperative workflow. Patients’ management algorithms based on early discharge after biopsy optimize the patient’s personal experience and make the most efficient possible use of the available hospital resources. Many new trends are emerging, constantly improving patient care and safety, as well as surgical workflow. A parameter that must be considered is the cost-effectiveness of these devices and the possibility of using them on a daily basis. The decision to implement a new instrument in the surgical workflow should also be dependent on the number of procedures per year, the existing stereotactic equipment, and the experience of each center. Research on patients’ postbiopsy management is another mandatory approach to enhance the safety profile of stereotactic brain biopsy and patient satisfaction, as well as to reduce healthcare costs.

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Taking the knife to neurodegeneration: a review of surgical gene therapy delivery to the CNS

Perera,

Brock,

Ahmed

et al. 2024

Acta Neurochir

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Gene supplementation and editing for neurodegenerative disorders has emerged in recent years as the understanding of the genetic mechanisms underlying several neurodegenerative disorders increases. The most common medium to deliver genetic material to cells is via viral vectors; and with respect to the central nervous system, adeno-associated viral (AAV) vectors are a popular choice. The most successful example of AAV-based gene therapy for neurodegenerative disorders is Zolgensma© which is a transformative intravenous therapy given to babies with spinal muscular atrophy. However, the field has stalled in achieving safe drug delivery to the central nervous system in adults for which treatments for disorders such as amyotrophic lateral sclerosis are desperately needed. Surgical gene therapy delivery has been proposed as a potential solution to this problem. While the field of the so-called regenerative neurosurgery has yielded pre-clinical optimism, several challenges have emerged. This review seeks to explore the field of regenerative neurosurgery with respect to AAV-based gene therapy for neurodegenerative diseases, its progress so far and the challenges that need to be overcome.

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Accuracy of Robotic and Frame-Based Stereotactic Neurosurgery in a Phantom Model

Cited by 4 publications

References 25 publications

Minimally Invasive Destructive, Ablative, and Disconnective Epilepsy Surgery

Minimally Invasive Destructive, Ablative, and Disconnective Epilepsy Surgery

Advances, technological innovations, and future prospects in stereotactic brain biopsies

Taking the knife to neurodegeneration: a review of surgical gene therapy delivery to the CNS

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