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Frameless Robot-Assisted Deep Brain Stimulation Surgery: An Initial Experience.

Allen L Ho1, Arjun V Pendharkar1, Ryan Brewster1

  • 1Department of Neurosurgery, Stanford University School of Medicine, Stanford, California.

Operative Neurosurgery (Hagerstown, Md.)
|January 11, 2019
PubMed
Summary
This summary is machine-generated.

Robotic-assisted deep brain stimulation (DBS) surgery using a frameless system improved operative efficiency and accuracy while reducing complications. This initial experience demonstrates the safety and benefits of robotic assistance in DBS procedures.

Keywords:
DBSDeep brain stimulationFramelessMazorRobot-assistedRoboticStereotaxy

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Area of Science:

  • Neurosurgery
  • Medical Robotics
  • Stereotactic Surgery

Background:

  • Robotic-assist surgical systems enhance efficiency, accuracy, and safety in stereotaxy.
  • Experience with robotic systems in deep brain stimulation (DBS) surgery is limited.

Purpose of the Study:

  • To evaluate the initial use of a frameless robotic solution for image-guided stereotaxy in DBS surgery.
  • To report on operative efficiency, stereotactic accuracy, and complications.

Main Methods:

  • A cohort of 20 consecutive robot-assisted DBS patients was compared to 20 prior nonrobotic DBS cases.
  • Data collected included demographics, complications, operative times, and microelectrode recording (MER) passes.
  • Stereotactic accuracy was assessed using 2D radial and depth errors.

Main Results:

  • Robot-assisted DBS significantly decreased mean operative times (P < .02) and MER passes (P < .001).
  • Operative efficiency improved over time in the robot-assisted cohort.
  • Mean radial error was 1.40 ± 0.11 mm and mean depth error was 1.05 ± 0.18 mm.

Conclusions:

  • This is the first report on frameless robotic-assistance (Mazor Renaissance) for DBS surgery.
  • Initial experience indicates the system is safe and positively impacts operative efficiency, accuracy, and safety.