Frameless robotically targeted stereotactic brain biopsy: feasibility, diagnostic yield, and safety

Area of Science:

• Neurosurgery
• Medical Robotics
• Image-Guided Surgery

Background:

• Frameless stereotactic brain biopsy is a standard neurosurgical procedure.
• Robotic advancements aim to enhance safety, efficacy, and efficiency in stereotactic biopsies.
• The study investigates the utility of robotic assistance in frameless stereotactic brain biopsy.

Purpose of the Study:

• To evaluate the safety, accuracy, and diagnostic yield of robotic-assisted frameless stereotactic brain biopsy.
• To compare the robotic approach with existing stereotactic biopsy methods.
• To assess the efficiency and complication profile of robotic brain biopsy.

Main Methods:

• Retrospective analysis of 41 patients undergoing robotic-assisted frameless stereotactic brain biopsy.
• Utilized the SurgiScope system with scalp fiducial markers and preselected targets/trajectories.
• Performed 45 procedures targeting 50 supratentorial lesions.

Main Results:

• Mean operative time was 44.6 minutes, decreasing significantly over the study period.
• Achieved a high diagnostic yield of 97.8% per procedure.
• Reported a low complication rate of 4% (one transient, one permanent deficit), with no infections.

Conclusions:

• Robotic-assisted frameless stereotactic biopsy is safe, accurate, and efficient.
• The procedure demonstrates comparable safety and efficacy to frame-based and non-robotic frameless methods.
• Robotic planning allows for optimized trajectories, enabling biopsy of small lesions and avoidance of critical structures.