Artikel
Comparing different methods for biopsy of intracranial lesions – robot-guided surgery versus classic frame-based stereotaxy
Biopsie intrakranieller Läsionen – roboterassistierte und klassische stereotaktische Serienbiopsie im Vergleich
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Autoren
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Andrea Spyrantis
- Goethe Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
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Johanna Quick-Weller
- Goethe Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
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Adriano Cattani
- Goethe Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
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Laurent Willems
- Goethe Universität Frankfurt am Main, Neurologie, Frankfurt am Main, Deutschland
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Volker Seifert
- Goethe Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
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Thomas Freiman
- Goethe Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: With the introduction of the ROSA robot in our department in 2015, we have acquired an alternative to classic stereotactic surgery. In this study, we compare ROSA and stereotactic biopsies regarding time efficiency, complications and histopathological results.
Methods: We included all patients who underwent robot guided or classic stereotactic biopsy from 2015 to 03/2018. 125 patients had ROSA guided surgery, 230 patients were operated using the classic stereotactic procedure. Patient files were analyzed regarding procedure time, complications related to the procedure and therapy guiding histopathological findings.
Results: We performed 126 robot-guided biopsies in 125 patients, 71 male, 54 female. The mean age was 57, ranging from 1 to 85 years old. In 2 cases the histopathological finding was inconclusive, all other biopsies resulted in a diagnosis (98%). We identified 7 postoperative hemorrhages, 4 of them clinically silent. In 3 patients, neurological deficits due to postoperative hemorrhages were diagnosed (2%). In the same period of time, stereotactic biopsies were performed in 230 patients, 183 male, 159 female, with a mean age of 55. The youngest patient was 2, the oldest 87 years of age. In 91% a diagnosis could be established. We identified 17 postoperative hemorrhages, 8 of them relevant (3%). The average time spent in the operating room amounted to 146 min in robot guided biopsies and 113 min in stereotaxy, the average overall procedure time including anesthesia and in stereotactic procedures a CT scan, amounted to 172 min and 178 min, respectively.
Conclusion: With both methods, a diagnosis can be found most cases, complication rates and the overall procedure time are comparable. Whereas in classic frame-based stereotaxy, a thin-layer CCT scan is required, most of the robot guided procedures were performed without a CT scan, saving radiation for the patient. As the robot-guided procedure does not require a frame, very young children and babies can get a biopsy and therefore, a diagnosis.
