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Robot-assisted procedures in pediatric neurosurgery.

Alessandro De Benedictis1, Andrea Trezza1,2, Andrea Carai1

  • 1Department of Neuroscience and Neurosurgical Unit and.

Neurosurgical Focus
|May 3, 2017
PubMed
Summary

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The Robotized Stereotactic Assistant (ROSA) system enhances pediatric neurosurgery safety and feasibility. This robotic approach optimizes surgical outcomes and minimizes complications in children undergoing complex procedures.

Area of Science:

  • Neurosurgery
  • Robotic Surgery
  • Pediatric Medicine

Background:

  • Robotic technology has advanced surgical fields, offering improved precision and safety.
  • Neurosurgery, particularly in pediatric patients with complex anatomy, can benefit from enhanced accuracy and safety.
  • The application of robotic assistance in pediatric neurosurgery remains underreported.

Purpose of the Study:

  • To describe the experience and outcomes of using the ROSA device in pediatric neurosurgical procedures.
  • To evaluate the safety, feasibility, and efficacy of robot-assisted neurosurgery in children.
  • To present the largest reported series of robotic-assisted pediatric neurosurgical cases.

Main Methods:

  • A retrospective analysis of 116 pediatric patients undergoing 128 ROSA-assisted neurosurgical procedures between 2011 and 2016.
Keywords:
DBS = deep brain stimulationEPLE = entry point localization errorGPI = globus pallidus internusHH = hypothalamic hamartomaROSA = Robotized Stereotactic AssistantSEEG = stereo-electroencephalographyTPLE = target point localization errorminimally invasive neurosurgerypediatric neurosurgeryrobotics

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  • Procedures included electrode implantation, neuroendoscopy, stereotactic biopsy, pallidotomy, shunt placement, deep brain stimulation, and cyst aspiration.
  • Methods involved preoperative planning, frameless registration, robotic arm-guided surgery, and postoperative imaging.

    • Main Results:

    • The ROSA system demonstrated improved safety and feasibility for minimally invasive pediatric neurosurgical approaches.
    • Surgical outcomes were optimized, and postoperative morbidity was minimized across various procedures.
    • Accuracy, timing, and complication rates were analyzed for each surgical intervention.

    Conclusions:

    • The ROSA system is a valuable tool for pediatric neurosurgery, enhancing minimally invasive procedures.
    • Robot-assisted surgery with the ROSA device offers improved safety and optimizes surgical results in children.
    • This study represents the largest series of robotic-assisted pediatric neurosurgical cases, highlighting the system's potential.