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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Increasing accessibility of the temporal lobe for biopsies by novel head-mounted robot

Meeting Abstract

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  • Georgios Naros - Sektion Funktionelle und Restaurative Neurochirurgie und Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Florian Grimm - Sektion Funktionelle und Restaurative Neurochirurgie und Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • Alireza Gharabaghi - Sektion Funktionelle und Restaurative Neurochirurgie und Klinik für Neurochirurgie, Universitätsklinikum Tübingen

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 079

doi: 10.3205/15dgnc477, urn:nbn:de:0183-15dgnc4772

Published: June 2, 2015

© 2015 Naros et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Frame-based stereotaxy is the gold standard for biopsies or electrode implantations in precarious brain regions. However, the accessibility of the temporal lobe for frame-based stereotactic procedures is constricted by the dimensions and mounting of the head ring resulting in compromises in trajectory planning and surgical approach to the target. Novel robot-guided stereotaxy systems could help to overcome these constraints.

Method: Five consecutive patients (63 ± 21 years [mean ± SD], range: 27 - 80 years, 1 female) with temporal lesions (2x astrocytoma WHO° II, 1x astrocytoma WHO°III, 2x astrocytoma WHO°IV) underwent a robot-guided biopsy with a head-mounted device. Feasibility of this new robotic device in temporal lobe biopsies and the range of possible trajectories were evaluated. Diagnostic yield and perioperative complications were documented.

Results: In all cases a safe trajectory to the lesion could be assigned. In two cases a ventro-dorsal direction of the trajectory was preferred. Postoperative CT scans confirmed accurate biopsy. There were no perioperative complications such as bleedings or postoperative neurological deficits. Histological diagnosis was confirmed in all except of one patient due to undersized tissue sample.

Conclusions: The new head-mounted device was applied successfully in temporal lobe biopsies. The presented technology increases neurosurgeon’s freedom in entry point selection and trajectory planning, thereby augmenting the accessibility of the temporal lobe for biopsies or electrode implantations.