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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Stereotactic robot assisted implantation of multiple depth electrodes in children with therapy refractory epilepsy: significant time saving with highest accuracy

Meeting Abstract

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  • Manfred Kudernatsch - Schön Klinik Vogtareuth, Abteilung für Neurochirurgie und Epilepsiechirurgie
  • Bastian Storzer - Schön Klinik Vogtareuth, Abteilung für Neurochirurgie und Epilepsiechirurgie
  • Tom Pieper - Schön Klinik Vogtareuth, Abteilung für Neuropädiatrie

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.16.08

doi: 10.3205/14dgnc367, urn:nbn:de:0183-14dgnc3679

Published: May 13, 2014

© 2014 Kudernatsch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Stereo-electroencephalography (SEEG) is an invasive diagnostic tool for the evaluation of drug resistant epilepsy. It is sometimes necessary to use up to 20 electrodes in multiple lobes or even bihemispheric for further diagnostics. The conventional stereotactic method is the gold standard for accuracy but the time of surgery increases with every electrode (20-30 min per electrode). With a specific Robot assisted operation system which purports the planned implantations trajectories automatically the time of surgery decreases under 10 min per electrode. We report on our initial experiences with the combination of a robot assisted system and a stereotactic frame to connect a short surgery time with high precision.

Method: Preoperative the trajectories were planned with MRI datas. Before operation the fixation of the frame (Leksell) was done and then a CT scan performed. The datas of MRI and CT were fused and the frame was connected to the robot system (ROSA, Medtech) in the operation room. The Implantation of the electrodes (Adtech) was performed with robot-guidance in the common way.

Results: Between 2011-2013 19 patients underwent SEEG implantation with an overall of 247 electrodes and an average implantation time of 9 minutes per electrode. Mean age was 12 (range 7-23 years). The average aberration at the point of entry calculated by fusion of preoperative and postoperative MRI was 0,6 mm.

Conclusions: With the combination of stereotactic method and robotic assistance system a high accuracy with a short operation time can be achieved when implanting multiple electrodes for SEEG.