Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, China.
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
J Robot Surg. 2023 Jun;17(3):1013-1020. doi: 10.1007/s11701-022-01504-8. Epub 2022 Dec 1.
The original stereoelectroencephalography frame-based implantation technique has been proven to be safe and effective. But this procedure is complicated and time-consuming. With the development of modern robotic technology, robot-guided intracerebral electrodes implantation is being implemented at many epilepsy centers. We retrospectively analyzed the results of 147 patients who underwent SEEG electrode implantation surgery at our hospital. Robot-guided surgery was performed on 87 patients from January 2018 to December 2019. The remaining 60 patients received frame-based surgery from June 2015 to June 2016. 147 patients underwent a total of 149 SEEG electrode implantation procedures. The mean error of the entry point of the robot-guided surgery group was lower than that of the frame-based surgery group (1.48 ± 1.46 mm vs. 1.59 ± 0.9 mm, P < 0.001). Also, the robot group had a higher mean number of electrodes per patient (8.9 ± 2.2 vs. 7.9 ± 2.5, P = 0.004), a significantly shorter mean operative time (69.5 ± 23.3 min vs. 106.8 ± 39.8 min, P < 0.001), and mean time per electrode (7.9 ± 1.3 min vs. 13.5 ± 3.1 min, P < 0.001) than the frame-based group. In the robot-guided group, the target point (TP) error was positively correlated with skull thickness (P = 0.001) and negatively correlated with the electrode-skull angle (P = 0.041). The mean target point error and hemorrhage rates were also analyzed, but no differences were observed between the two groups. Robot-guided surgery has a higher entry point accuracy and efficiency. Electrode implantation accuracy was affected by the skull thickness and electrode-skull angle.
原始的立体定向脑电图框架植入技术已被证明是安全有效的。但该程序复杂且耗时。随着现代机器人技术的发展，机器人引导颅内电极植入术正在许多癫痫中心实施。我们回顾性分析了我院 147 例行 SEEG 电极植入术患者的结果。2018 年 1 月至 2019 年 12 月，对 87 例患者进行了机器人引导手术。其余 60 例患者于 2015 年 6 月至 2016 年 6 月接受了基于框架的手术。147 例患者共进行了 149 例 SEEG 电极植入术。机器人引导手术组的入口点误差平均值低于基于框架手术组（1.48±1.46mm 比 1.59±0.9mm，P<0.001）。此外，机器人组每位患者的平均电极数较高（8.9±2.2 比 7.9±2.5，P=0.004），平均手术时间较短（69.5±23.3min 比 106.8±39.8min，P<0.001），平均每个电极的时间较短（7.9±1.3min 比 13.5±3.1min，P<0.001）。与基于框架的组相比。在机器人引导组中，目标点（TP）误差与颅骨厚度呈正相关（P=0.001），与电极-颅骨角度呈负相关（P=0.041）。还分析了平均目标点误差和出血率，但两组之间无差异。机器人引导手术具有更高的入口点准确性和效率。电极植入的准确性受颅骨厚度和电极-颅骨角度的影响。
