Robot-assisted stereotactic electroencephalography using 3-dimensional intraoperative imaging and frameless...

Area of Science:

• Neurosurgery
• Epileptology
• Medical Robotics

Background:

• Stereoelectroencephalography (SEEG) is crucial for mapping epileptic networks in drug-resistant epilepsy.
• Traditional SEEG setup can be complex and time-consuming in the operating room.
• Robot-assisted SEEG offers potential benefits but faces installation challenges.

Purpose of the Study:

• To demonstrate a streamlined surgical technique for robot-assisted SEEG using advanced robotic and imaging tools.
• To illustrate the step-by-step workflow for robotic SEEG implantation.
• To highlight the advantages of new robotic systems in SEEG procedures.

Main Methods:

• Utilized a robotic arm (neuromate) for SEEG electrode placement.
• Employed a frameless registration system (neurolocate) for guidance.
• Integrated an intraoperative flat-panel CT scanner (O-arm) for real-time imaging and registration.

Main Results:

• The described technique facilitates easier setup compared to traditional stereotactic frames.
• Achieved high mechanical precision in electrode placement.
• Demonstrated a potentially lower complication rate with the robotic approach.

Conclusions:

• Robot-assisted SEEG, when combined with advanced robotic tools and intraoperative imaging, offers an efficient and precise method for epilepsy network investigation.
• This technique simplifies the surgical workflow and maintains high standards of accuracy.
• The presented video serves as a practical guide for implementing this advanced SEEG procedure.