Frameless Stereotactic Robot-Assisted Subthalamic Nucleus Deep Brain Stimulation: Case Report.

Area of Science:

• Neurosurgery
• Robotics in Medicine
• Medical Device Technology

Background:

• Traditional frame-based systems are the gold standard for deep brain stimulation (DBS) electrode implantation due to accuracy.
• Robotic stereotactic systems offer ease of use and reliability but raise safety concerns in the US.
• This report details the first DBS implantation in North America using the FDA-approved ROSA robotic device.

Observation:

• A 56-year-old female patient with a 12-year history of Parkinson disease underwent bilateral subthalamic nucleus DBS.
• The procedure utilized ROSA robotic stereotactic assistance, integrating preoperative MRI with intraoperative CT for precise electrode placement.
• The surgery was completed successfully with electrodes placed bilaterally without complications.

Findings:

• Robotic assistance in stereotactic procedures offers improved accuracy.
• The ROSA system provides an "arc-less" approach, simplifying the surgical setup.
• The robotic system allows for minor trajectory adjustments in multiple planes without repositioning the patient's head frame.

Implications:

• Robotic stereotactic assistance is a viable alternative to traditional frame-based and frameless systems for DBS surgery in US hospitals.
• This technology has the potential to enhance the safety and efficacy of neurosurgical interventions.
• The successful implementation of the ROSA robot marks a significant advancement in minimally invasive neurosurgery.