Asleep Robot-Assisted Surgery for the Implantation of Subthalamic Electrodes Provides the Same Clinical Improvement and Therapeutic Window as Awake Surgery

Lefranc, Michel; Zouitina, Yassine; Tir, Mélissa; Merle, P; Ouendo, Martial; Constans, Jean-Marc; Godefroy, Olivier; Peltier, Johann; Krystkowiak, Pierre

doi:10.1016/j.wneu.2017.07.047

Cited by 33 publications

(24 citation statements)

References 35 publications

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“…Interestingly, on a phantom study, Lefranc et al showed that registration with CT scan or 3D‐fp‐CT‐scan provided the best results in terms of accuracy. At the target, the accuracy was 0.3 mm with CT scan and 3D‐fp‐CT‐scan vs 1.59 mm with 3T‐MRI . In our procedure, surgical planning is performed with MRI and CT scan, and a 3D‐fp‐CT‐scan with bone screws is performed the day of the surgery.…”

Section: Discussionmentioning

confidence: 99%

“…For biopsy (except pineal lesion and some brainstem lesion), a non‐invasive registration (surface laser registration) is used. In clinical application, Lefranc et al showed that mean accuracy was equal to 0.42 mm when the procedure included 3D‐fp‐CT‐scan imaging and invasive bone fiducial registration compared with 1.22 mm when surface recognition is used.…”

Section: Discussionmentioning

confidence: 99%

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Accuracy of the robot‐assisted procedure in deep brain stimulation

Goia

Gilard

Lefaucheur

et al. 2019

Robotics Computer Surgery

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Introduction:The use of a robot-assisted technology becomes very competitive.The aim of this work was to define the accuracy of robotic assistance in deep brain stimulation surgery and to compare results with that in the literature. Methods:We retrospectively reviewed the accuracy of lead implantation in 24 consecutive patients who had robot-assisted (ROSA, Zimmer-Biomet) surgery for the treatment of movement disorders. Intended stereotactic coordinates (x, y, z) of contact 0 (the most distal contact at the tip of the electrode) of each definitive lead were compared with actual coordinates obtained by a postoperative CT scan. For each lead, the euclidian 3D distance between the actual and intended location of contact 0 was calculated. Results:The euclidian 3D distances between the intended and actual location of the contact 0 were 0.81 mm on the right side and 1.12 mm on the left side.Discussion: Robot-assisted technology for stereotactic surgery is safe and accurate. The association with a 3D flat-panel CT scan is an optimized procedure for deep intracranial electrode implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Accuracy of the robot‐assisted procedure in deep brain stimulation

Goia

Gilard

Lefaucheur

et al. 2019

Robotics Computer Surgery

View full text Add to dashboard Cite

show abstract

“…In the short term, the UPDRS III score in the “off‐drug, on‐stim” condition fell to a similar extent in the LA and GA groups (by 40.3% and 49%, respectively, p = 0.336). Therefore, they concluded that asleep robot‐assisted implantation of STN‐DBS electrodes (with accurate identification of the STN and positioning of the DBS lead) produced the same motor results and therapeutic window as awake surgery .…”

Section: Clinical Outcomesmentioning

confidence: 99%

Comparison of Awake and Asleep Deep Brain Stimulation for Parkinson’s Disease: A Detailed Analysis Through Literature Review

Wang

Ponce

Tao

et al. 2020

Neuromodulation: Technology at the Neural Interface

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“…Almost half of our cohort expressed this fear. Discussing the option of DBS implantation under general anesthesia, which has been shown to be as efficacious as its awake counterpart (35)(36)(37)(38)(39)(40), may reduce this apprehension and thus help reduce the aforementioned under-utilization of DBS.…”

Section: Timing Of Dbs Surgerymentioning

confidence: 99%

Capturing Initial Understanding and Impressions of Surgical Therapy for Parkinson's Disease

et al. 2021

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Background: Deep Brain Stimulation (DBS) is an underutilized surgical therapy for Parkinson's Disease (PD). Both physician and patient hesitancies have been described as potential barriers to DBS, but the specifics of patient perceptions of DBS have not been well-characterized in the general PD population.Objective: To characterize the understanding and impressions of surgical therapy in PD patients prior to formal surgical evaluation.Methods: A 30-question survey assessing impressions of surgical therapy for PD and understanding of DBS for PD was administered to PD patients seen at an urban movement disorders clinic.Results: One hundred and two patients completed the survey. When asked if they would undergo a hypothetical risk-free, curative brain surgery for PD, 98 patients responded “yes.” Patients were more agreeable to “reversible,” “minimally-invasive,” and “incisionless” surgery. 51.2% thought DBS is an “effective” treatment for PD, 76.6% thought it was “invasive,” and 18.3% thought it was “reversible.” 45.2% reported fear of being awake during DBS surgery. Regarding costs, 52.4% were concerned that DBS was “very expensive” or “not covered by insurance.” Initial source of information and perceived treatment effectiveness were not associated with concerns about DBS effectiveness or threats to normality. Negative perceptions of past surgery were associated with concerns about DBS altering mood and personality.Conclusion: Overall, patients expressed concerns regarding procedural efficacy, invasiveness, cost, and irreversibility—independent of the original source of information. Future studies are required to allow us to better understand the impact of these initial findings on DBS hesitancy and underutilization.

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Asleep Robot-Assisted Surgery for the Implantation of Subthalamic Electrodes Provides the Same Clinical Improvement and Therapeutic Window as Awake Surgery

Cited by 33 publications

References 35 publications

Accuracy of the robot‐assisted procedure in deep brain stimulation

Accuracy of the robot‐assisted procedure in deep brain stimulation

Comparison of Awake and Asleep Deep Brain Stimulation for Parkinson’s Disease: A Detailed Analysis Through Literature Review

Capturing Initial Understanding and Impressions of Surgical Therapy for Parkinson's Disease

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