Usefulness of Robotic Stereotactic Assistance (ROSA^®) Device for Stereoelectroencephalography Electrode Implantation:...

Area of Science:

• Neurosurgery
• Medical Robotics
• Epilepsy Research

Background:

• Drug-resistant epilepsy necessitates advanced surgical interventions like stereoelectroencephalography (SEEG).
• Accurate SEEG electrode placement is crucial for effective diagnosis and treatment planning.
• Evaluating novel robotic assistance systems for SEEG implantation is essential for improving surgical efficiency and patient outcomes.

Approach:

• Systematic review and meta-analysis of relevant studies adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Literature search identified 855 articles, with 15 selected for meta-analysis, encompassing 11,257 SEEG electrode implantations.
• Comparative analysis focused on electrode placement accuracy, operative time, perioperative complications, and seizure outcomes between ROSA-assisted and conventional techniques.

Key Points:

• ROSA-assisted SEEG implantation significantly reduced overall operative time (mean difference -63.45 min) and time per electrode (mean difference -8.79 min) compared to frame-based or navigation-assisted methods.
• While comprehensive accuracy evaluation was limited by comparative study numbers, ROSA demonstrated efficiency gains.
• No significant differences were observed in perioperative complications or seizure outcomes between ROSA-assisted and other SEEG implantation techniques.

Conclusions:

• The Robotic Stereotactic Assistance (ROSA) device is an effective and safe tool for trajectory-guided SEEG electrode implantation in drug-resistant epilepsy.
• ROSA offers substantial benefits in reducing operative time for SEEG procedures.
• The use of ROSA does not elevate the risk of perioperative complications or adversely affect seizure outcomes, supporting its clinical utility.