Robot-assisted versus stereotactic frame-based stereoelectroencephalography in medically refractory epilepsy

Area of Science:

• Neurosurgery
• Epileptology
• Medical Robotics

Background:

• Stereoelectroencephalography (SEEG) is crucial for localizing the epileptogenic zone in medically refractory epilepsy.
• Traditional stereotactic frame-based (SF) SEEG placement can be time-consuming.
• Robot-assisted (RA) SEEG offers potential advancements in surgical procedures.

Purpose of the Study:

• To compare the efficacy and safety of robot-assisted (RA) SEEG versus stereotactic frame-based (SF) SEEG.
• To evaluate differences in procedural efficiency and accuracy between RA and SF SEEG techniques.
• To assess the impact of RA SEEG on electrode placement and operative time.

Main Methods:

• Retrospective review of 33 SEEG cases (14 SF, 19 RA).
• Detailed analysis of medical histories, operative records, imaging, and trajectory plans.
• Multiple linear regression used to identify factors influencing placement error.

Main Results:

• RA SEEG utilized more electrodes per patient (10.7 vs. 6.4) with significantly shorter operative times (127.3 min vs. 152.7 min).
• In RA SEEG, longer implantation depth correlated with increased target point, depth, and radial errors.
• Skull thickness negatively correlated with placement errors in RA SEEG.
• No significant differences were found in entry/target point errors, depth errors, radial errors, complication rates, or epileptogenic zone localization outcomes between SF and RA groups.

Conclusions:

• Robot-assisted SEEG demonstrates significantly greater efficiency compared to stereotactic frame-based SEEG.
• RA SEEG is comparable to SF SEEG in terms of safety and effectiveness for epilepsy surgery.
• RA SEEG represents a viable and efficient alternative for SEEG procedures.