Abstract:
BACKGROUND/AIMS:Technological advancements had a serious impact on the evolution of robotic systems in stereotactic neurosurgery over the last three decades and may turn robot-assisted stereotactic neurosurgery into a sophisticated alternative to purely mechanical guiding devices. OBJECTIVES:To compare robot-assisted and conventional frame-based deep brain stimulation (DBS) surgery with regard to accuracy, precision, reliability, duration of surgery, intraoperative imaging quality, safety and maintenance using a standardized setup. METHODS:Retrospective evaluation of 80 consecutive patients was performed who underwent DBS surgery using either a frame-based mechanical stereotactic guiding device (n = 40) or a stereotactic robot (ROSA Brain, MedTech, Montpellier, France) (n = 40). RESULTS:The mean accuracy of robot-assisted and conventional lead implantation was 0.76 mm (SD: 0.37 mm, range: 0.17-1.52 mm) and 1.11 mm (SD: 0.59 mm, range: 0.10-2.90 mm), respectively. We observed a statistically significant difference in accuracy (p < 0.001) when comparing lateral deviations between both modalities. Furthermore, a statistical significance was observed when investigating the proportion of values exceeding 2.00 mm between both groups (p = 0.013). In 8.75% (n = 7) of conventionally implanted leads, lateral deviations were greater than 2.0 mm. With a maximum value of 1.52 mm, this threshold was never reached during robot-guided DBS. The mean duration of DBS surgery could be reduced significantly (p < 0.001) when comparing robot-guided DBS (mean: 325.1 ± 81.6 min) to conventional lead implantation (mean: 394.8 ± 66.6 min). CONCLUSIONS:Robot-assisted DBS was shown to be superior to conventional lead implantation with respect to accuracy, precision and operation time. Improved quality control, continuous intraoperative monitoring and less manual adjustment likely contribute to the robotic system's reliability allowing high accuracy during lead implantation despite limited experience. Hence, robot-assisted lead implantation can be considered an appropriate and reliable alternative to purely mechanical devices.
journal_name
Stereotact Funct Neurosurgjournal_title
Stereotactic and functional neurosurgeryauthors
Neudorfer C,Hunsche S,Hellmich M,El Majdoub F,Maarouf Mdoi
10.1159/000494736subject
Has Abstractpub_date
2018-01-01 00:00:00pages
327-334issue
5eissn
1011-6125issn
1423-0372pii
000494736journal_volume
96pub_type
杂志文章abstract::Computed tomographic (CT), magnetic resonance (MR), MR angiographic and angiographic images, obtained after complete nidus obliteration had been angiographically confirmed, were reviewed in 9 patients who had undergone Gamma Knife treatment for cerebral arteriovenous malformations (AVMs). The period between angiograph...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098772
更新日期:1995-01-01 00:00:00
abstract::Although technological advances have reduced device-related complications, DBS surgery still carries a significant risk of transient and permanent complications. We report our experience in 86 patients and 149 DBS implants. Patients with Parkinson's disease, essential tremor and dystonia were treated. There were 8 per...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000064600
更新日期:2001-01-01 00:00:00
abstract::Today's image guidance systems are the foundation of minimally invasive diagnosis and therapy and are the basis for the rational design of the neurosurgical operating room of the future. The building blocks of this procedural arena will be (1) high-resolution MR/CT anatomic imaging supplemented with (2) functional ima...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000029773
更新日期:1999-01-01 00:00:00
abstract::In this study, we investigated the efficacy of brachytherapy in the treatment of 138 patients with intracranial neoplasms of the CNS. Of the total number of patients, 50 presented with glioblastoma multiforme, 45 presented with low-grade glioma, 19 presented with anaplastic astrocytoma, 23 presented with metastases an...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000075100
更新日期:2003-01-01 00:00:00
abstract::In many cases, the treatment of neuropathic pain by intrathecal opioids fails to meet expectations. In a trial involving 10 patients, the intrathecal administration of clonidine combined with opioids in the treatment of chronic pain was introduced in our department for the first time. Eight patients with neuropathic p...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000048402
更新日期:2000-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099402
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,随机对照试验
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更新日期:2012-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
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更新日期:1996-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
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doi:10.1159/000366004
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
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更新日期:2020-09-09 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100257
更新日期:1990-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099539
更新日期:1989-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000075161
更新日期:2003-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Gamma knife surgery (GKS) is used at subnecrotic doses for temporal lobe epilepsy (TLE) treatment. Rat models of TLE have been used to probe the mechanisms underlying GKS. Previous GKS studies on rats have used the Leksell GammaPlan (LGP) treatment planning system to determine the irradiation time to achieve...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000314355
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journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
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更新日期:1996-01-01 00:00:00
abstract::Fractionated stereotactic radiotherapy is a method which attempts to combine the radiobiological advantages offered by dose fractionation with a technique for focal delivery of radiation. At McGill University, fractionated stereotactic radiotherapy is given with a linear accelerator-based dynamic stereotactic radiosur...
journal_title:Stereotactic and functional neurosurgery
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journal_title:Stereotactic and functional neurosurgery
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更新日期:2002-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1159/000319958
更新日期:2010-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000066710
更新日期:2001-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029708
更新日期:1999-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000280823
更新日期:2010-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000064605
更新日期:2001-01-01 00:00:00
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
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journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000098621
更新日期:1994-01-01 00:00:00