Frame-based versus robot-assisted stereo-electro-encephalography for drug-resistant epilepsy

Area of Science:

• Neurosurgery
• Epileptology
• Medical Robotics

Background:

• Stereoelectroencephalography (SEEG) is a crucial invasive evaluation for drug-resistant epilepsies.
• Robotic devices offer a simplified, accurate, and safe alternative to conventional SEEG techniques.
• This study details institutional experience with robot-assisted SEEG, comparing its performance to traditional methods.

Purpose of the Study:

• To compare the in vivo accuracy of robot-assisted SEEG with conventional SEEG.
• To evaluate the operational efficiency and safety of robot-assisted SEEG.
• To report technical advancements and institutional experience with robotic SEEG.

Main Methods:

• Patients with medically refractory focal epilepsy undergoing SEEG from 2014-2022 were included.
• Technical aspects of robot-assisted SEEG were described.
• Analyses included patient demographics, electrode implantation accuracy, operation time, and complications.

Main Results:

• Robot-assisted SEEG showed a significantly reduced median operation time (77.5 min vs. 90 min).
• Target point localization error was significantly lower with the robot-assisted approach (1.8 mm vs. 2.8 mm).
• Total complication rates were comparable (11.5% robot-assisted vs. 17.7% conventional).

Conclusions:

• SEEG is a safe and accurate method for guiding epilepsy surgery.
• Integrating robotic devices with SEEG can enhance surgical safety, efficiency, and accuracy.
• Robot-assisted SEEG represents a valuable advancement in presurgical epilepsy evaluation.