[Practical Applications of Robot Systems in Epilepsy Surgery]

Area of Science:

• Neurosurgery
• Epileptology
• Medical Technology

Background:

• Subdural electrode (SDE) and stereotactic electroencephalography (SEEG) are key epilepsy surgery monitoring methods.
• Robotic systems are shifting North American epilepsy surgery towards SEEG implantation.
• Robot-assisted SEEG is gaining traction globally, including insurance coverage in Japan.

Purpose of the Study:

• To provide a comprehensive overview of SEEG.
• To detail SEEG indications, robotic implantation methods, and advantages.
• To discuss SEEG risks and compare it to other monitoring techniques.

Main Methods:

• Stereotactic insertion of intracerebral depth electrodes through small holes, avoiding craniotomy.
• Meticulous planning of electrode trajectories using 3D gadolinium-enhanced MRI to avoid vasculature.
• Utilizing commercially available surgical robotic systems for precise and efficient electrode placement.

Main Results:

• Robotic technology enables precise and efficient SEEG depth electrode placement.
• SEEG allows sampling of superficial cortical areas, sulcal bottoms, and deep brain structures.
• SEEG eliminates the need for craniotomy, unlike SDE implantation.

Conclusions:

• SEEG, particularly with robotic assistance, represents an advancement in epilepsy monitoring.
• Robotic SEEG offers superior anatomical coverage compared to SDE.
• The adoption of SEEG is increasing due to technological advancements and improved accessibility.