Minimally Invasive, Endoscopic-Assisted Device for Subdural Electrode Implantation in Epilepsy

Area of Science:

• Neurosurgery
• Medical Devices
• Epilepsy Surgery

Background:

• Subdural grids and strip electrodes are crucial for mapping eloquent cortex and defining seizure onset zones.
• Traditional implantation requires large craniotomies, increasing risks of complications like hemorrhage and infection.

Purpose of the Study:

• To introduce a novel device for minimally invasive subdural electrode implantation.
• To evaluate the feasibility and safety of this endoscopic-assisted approach.

Main Methods:

• A skull-mounted device was developed for electrode placement through a keyhole craniotomy.
• A flexible neurovideoscope provided direct visualization of the cerebral cortex during implantation.
• Cadaveric studies assessed craniotomy size, electrode deployment range, and cortical integrity.

Main Results:

• The device facilitated subdural electrode placement through a 40-mm craniotomy.
• Electrodes were deployed up to 70 mm from the craniotomy center without damaging the cortex.
• No visual cortical damage was observed post-procedure.

Conclusions:

• This novel, minimally invasive, endoscopically assisted device allows for safe implantation of subdural electrodes.
• It enables direct visualization with limited craniotomy size, avoiding temporalis muscle incision and reducing complication risks.