Primary Experiences with Robot-assisted Navigation-based Frameless Stereo-electroencephalography: Higher Accuracy than Neuronavigation-guided Manual Adjustment.

Journal: Neurologia medico-chirurgica
PMID:

Abstract

The use of robot-assisted frameless stereotactic electroencephalography (SEEG) is becoming more common. Among available robotic arms, Stealth Autoguide (SA) (Medtronic, Minneapolis, MN, USA) functions as an optional instrument of the neuronavigation system. The aims of this study were to present our primary experiences with SEEG using SA and to compare the accuracy of implantation between SA and navigation-guided manual adjustment (MA). Seventeen electrodes from two patients who underwent SEEG with SA and 18 electrodes from four patients with MA were retrospectively reviewed. We measured the distance between the planned location and the actual location at entry (De) and the target (Dt) in each electrode. The length of the trajectory did not show a strong correlation with Dt in SA (Pearson's correlation coefficient [r] = 0.099, p = 0.706) or MA (r = 0.233, p = 0.351). De and Dt in SA were shorter than those in MA (1.99 ± 0.90 vs 4.29 ± 1.92 mm, p = 0.0002; 3.59 ± 2.22 vs 5.12 ± 1.40 mm, p = 0.0065, respectively). SA offered higher accuracy than MA both at entry and target. Surgical times per electrode were 38.9 and 32 min in the two patients with SA and ranged from 51.6 to 88.5 min in the four patients with MA. During the implantation period of 10.3 ± 3.6 days, no patients experienced any complications.

Authors

  • Yuichiro Kojima
    Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine.
  • Takehiro Uda
    Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine.
  • Toshiyuki Kawashima
    Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine.
  • Saya Koh
    Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine.
  • Masato Hattori
    Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine.
  • Yuki Mito
    Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine.
  • Noritsugu Kunihiro
    Department of Pediatric Neurosurgery, Osaka City General Hospital.
  • Shohei Ikeda
    Department of Pediatric Neurosurgery, Osaka City General Hospital.
  • Ryoko Umaba
    Department of Pediatric Neurosurgery, Osaka City General Hospital.
  • Takeo Goto
    From the Departments of Diagnostic and Interventional Radiology (D.U., A.Y., S.L.W., H. Tatekawa, H. Takita, T.H., A.S., Y.M.), Neurosurgery (T. Ichinose, H.A., Y.W., T.G.), and Medical Statistics (D.K.), Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan; and Department of Radiology, Osaka City University Hospital, 1-5-7 Asahi-machi, Abeno-ku, Osaka, 545-8586, Japan (Y.K., T. Ichida).