Robot-guided pediatric stereoelectroencephalography: single-institution experience

Area of Science:

• Neurosurgery
• Pediatric Epilepsy
• Robotic Surgery

Background:

• Stereoelectroencephalography (SEEG) is a crucial technique for localizing epileptogenic zones in drug-resistant epilepsy.
• Robot-guidance technology has shown promise in enhancing SEEG procedure efficiency, safety, and precision.
• Limited reports exist on the application of robot-guided SEEG in pediatric populations.

Purpose of the Study:

• To present the initial experience with the ROSA robotic guidance platform for SEEG in pediatric patients.
• To evaluate the safety, accuracy, efficiency, and epilepsy outcomes of robot-guided SEEG in children.

Main Methods:

• Retrospective analysis of 20 consecutive pediatric patients undergoing robot-guided SEEG with the ROSA platform between February 2016 and October 2017.
• Evaluation of medical/surgical history, imaging, trajectory plans, and operative records.
• Assessment of surgical accuracy, efficiency, safety, and epilepsy outcomes.

Main Results:

• A total of 222 leads were placed in 20 patients (average 11.1 leads/patient) with a mean radial error of 1.75 mm.
• Significant reductions in total and operative case times per lead were observed over the study period.
• Clinically useful data were obtained in 95% of cases, leading to epilepsy surgery in 95% of patients, with 50% achieving Engel class I outcome (seizure freedom).

Conclusions:

• Robot-guided SEEG with the ROSA platform can be rapidly adopted even in SEEG-naïve institutions with a minimal learning curve.
• This technology significantly decreases operating times while maintaining safety and achieving the goals of epileptogenic zone identification.
• Robot-guided SEEG demonstrates potential for improved epilepsy outcomes in pediatric patients.