Accuracy of the robot‐assisted procedure in deep brain stimulation

Goia, Alice; Gilard, Vianney; Lefaucheur, Romain; Welter, Marie‐Laure; Maltête, David; Derrey, Stéphane

doi:10.1002/rcs.2032

Cited by 25 publications

(24 citation statements)

References 26 publications

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“…Dlaka et al reporting 32 biopsy surgeries by the RONNA G3 robot calculated an entry point error of 1.42 ± 0.74 mm and target point error of 1.95 ± 1.11 mm ( 18 ). In addition, Alice Goia et al reported 44 lead implantations using the ROSA robot for deep brain stimulation surgery, observing target errors of 0.81 ± 0.51 mm on the right and 1.12 ± 0.75 mm on the left ( 19 ). This indicates that the accuracy of this study's Remebot-assisted biopsy procedure is comparable to that of other available robots, with a mean entry point error was 0.99 and a mean target error as low as 1.13 mm.…”

Section: Discussionmentioning

confidence: 99%

A Bulk Retrospective Study of Robot-Assisted Stereotactic Biopsies of Intracranial Lesions Guided by Videometric Tracker

Liu

Hua

et al. 2021

Front. Neurol.

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Background: Biopsies play an important role in the diagnosis of intracranial lesions, and robot-assisted procedures are increasingly common in neurosurgery centers. This research investigates the diagnoses, complications, and technology yield of 700 robotic frameless intracranial stereotactic biopsies conducted with the Remebot system.Method: This research considered 700 robotic biopsies performed between 2016 and 2020 by surgeons from the Department of Functional Neurosurgery in Beijing's Tiantan Hospital. The data collected included histological diagnoses, postoperative complications, operation times, and the accuracy of robotic manipulation.Results: Among the 700 surgeries, the positive rate of the biopsies was 98.2%. The most common histological diagnoses were gliomas, which accounted for 62.7% of cases (439/700), followed by lymphoma and germinoma, which accounted for 18.7% (131/700) and 7.6% (53/700). Bleeding was found in 14 patients (2%) by post-operation computed tomography scans. A total of 29 (4.14%) patients had clinical impairments after the operation, and 9 (1.29%) experienced epilepsy during the operation. The post-biopsy mortality rate was 0.43%. Operation time—from marking the cranial point to suturing the skin—was 16.78 ± 3.31 min (range 12–26 min). The target error was 1.13 ± 0.30 mm, and the entry point error was 0.99 ± 0.24 mm.Conclusion: A robot-assisted frameless intracranial stereotactic biopsy guided by a videometric tracker is an efficient, safe, and accurate method for biopsies.

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Section: Discussionmentioning

confidence: 99%

A Bulk Retrospective Study of Robot-Assisted Stereotactic Biopsies of Intracranial Lesions Guided by Videometric Tracker

Liu

Hua

et al. 2021

Front. Neurol.

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“…The initial search identified 625 publications, whereas after application of language filter 436 studies remained. A total of 25 full-text papers reporting the use of intraoperative imaging in DBS surgery matched the inclusion criteria [7,8,14,18,19,21,22,24,28,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46]. Data reported in this study were included for qualitative and quantitative analysis, totaling 26 papers.…”

Section: Intraoperative Image In Dbs Surgery: Systematic Review Of Thmentioning

confidence: 99%

O-Arm Stereotactic Imaging in Deep Brain Stimulation Surgery Workflow: A Utility and Cost-Effectiveness Analysis

Furlanetti¹,

Hasegawa²,

Oviedova³

et al. 2020

Stereotact Funct Neurosurg

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Introduction: Deep brain stimulation (DBS) surgery is an established treatment for movement disorders. Advances in neuroimaging techniques have resulted in improved targeting accuracy that may improve clinical outcomes. This study aimed to evaluate the safety and feasibility of using the Medtronic O-arm device for the acquisition of intraoperative stereotactic imaging, targeting, and localization of DBS electrodes compared with standard stereotactic MRI or computed tomography (CT). Methods: Patients were recruited prospectively into the study. Routine frame-based stereotactic DBS surgery was performed. Intraoperative imaging was used to facilitate and verify the accurate placement of the intracranial electrodes. The acquisition of coordinates and verification of the position of the electrodes using the O-arm were evaluated and compared with conventional stereotactic MRI or CT. Additionally, a systematic review of the literature on the use of intraoperative imaging in DBS surgery was performed. Results: Eighty patients were included. The indications for DBS surgery were dystonia, Parkinson’s disease, essential tremor, and epilepsy. The globus pallidus internus was the most commonly targeted region (43.7%), followed by the subthalamic nucleus (35%). Stereotactic O-arm imaging reduced the overall surgical time by 68 min, reduced the length of time of acquisition of stereotactic images by 77%, reduced patient exposure to ionizing radiation by 24.2%, significantly reduced operating room (OR) costs per procedure by 31%, and increased the OR and neuroradiology suite availability. Conclusions: The use of the O-arm in DBS surgery workflow significantly reduced the duration of image acquisition, the exposure to ionizing radiation, and costs when compared with standard stereotactic MRI or CT, without reducing accuracy.

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“…In 1994, Maciunas et al reported on more than 21,500 independent accuracy test measurements of a test phantom made with 11,000 computed tomography (CT) images and employing four commonly used stereotactic devices: the Brown-Roberts-Wells (BRW) frame, the Cosman-Roberts-Wells (CRW) frame, the Kelly-Goers Compass frame, and the Leksell frame (Table 1) [8]. In recent years, several groups have reported on inaccuracies during DBS procedures, including groups employing frameless systems and robot-assisted procedures (Table 1) [9][10][11][12][13][14][15][16][17][18][19][20][21]. On the basis of these results, one should take into account the possibility of a 3D inaccuracy of up to 2 mm of the applied stereotactic technique when targeting the dorsolateral STN, underlining the need for intraoperative imaging to verify lead localization.…”

Section: Accuracy Of the Stereotactic Techniquementioning

confidence: 99%

Targeting of the Subthalamic Nucleus in Patients with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery

2021

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Precise stereotactic targeting of the dorsolateral motor part of the subthalamic nucleus (STN) is paramount for maximizing clinical effectiveness and preventing side effects of deep brain stimulation (DBS) in patients with advanced Parkinson's disease. With recent developments in magnetic resonance imaging (MRI) techniques, direct targeting of the dorsolateral part of the STN is now feasible, together with visualization of the motor fibers in the nearby internal capsule. However, clinically relevant discrepancies were reported when comparing STN borders on MRI to electrophysiological STN borders during microelectrode recordings (MER). Also, one should take into account the possibility of a 3D inaccuracy of up to 2 mm of the applied stereotactic technique. Pneumocephalus and image fusion errors may further increase implantation inaccuracy. Even when implantation has been successful, suboptimal lead anchoring on the skull may cause lead migration during follow-up. Meticulous preand intraoperative imaging is therefore indispensable, and so is postoperative imaging when the effects of DBS deteriorate during follow-up. Thus far, most DBS centers employ MRI targeting, multichannel MER, and awake test stimulation in STN surgery, but randomized trials comparing surgery under local versus general anesthesia and additional studies comparing MER-STN borders to high-field MRI-STN may change this clinical practice. Further developments in imaging protocols and improvements in image fusion processes are needed to optimize placement of DBS leads in the dorsolateral motor part of the STN in Parkinson's disease.

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Accuracy of the robot‐assisted procedure in deep brain stimulation

Cited by 25 publications

References 26 publications

A Bulk Retrospective Study of Robot-Assisted Stereotactic Biopsies of Intracranial Lesions Guided by Videometric Tracker

A Bulk Retrospective Study of Robot-Assisted Stereotactic Biopsies of Intracranial Lesions Guided by Videometric Tracker

O-Arm Stereotactic Imaging in Deep Brain Stimulation Surgery Workflow: A Utility and Cost-Effectiveness Analysis

Targeting of the Subthalamic Nucleus in Patients with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery

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