gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Stereotactic robot assisted placement of intracerebral depth electrodes in paediatric and adult patients – accuracy, complications and epileptological results

Roboter-assistierte stereotaktische Implantation intrazerebraler Tiefenelektroden bei pädiatrischen und erwachsenen Patienten – Präzision, Komplikationen und epileptologische Ergebnisse

Meeting Abstract

  • presenting/speaker Thilo Kalbhenn - Evangelisches Klinikum Bethel, Neurochirurgie/Epilepsiechirurgie, Bielefeld, Deutschland
  • Hamzah Yasin - Evangelisches Klinikum Bethel, Klinik für Neurochirurgie, Bielefeld, Deutschland
  • Friedrich G. Woermann - Krankenhaus Mara, Epilepsie-Zentrum, Bielefeld, Deutschland
  • Thomas Cloppenborg - Krankenhaus Mara, Epilepsie-Zentrum, Bielefeld, Deutschland
  • Susanne Fauser - Krankenhaus Mara, Epilepsie-Zentrum, Bielefeld, Deutschland
  • Tilman Polster - Krankenhaus Mara, Epilepsie-Zentrum, Bielefeld, Deutschland
  • Roland Coras - Universitätsklinik Erlangen, Neuropathologisches Institut, Erlangen, Deutschland
  • Christian G. Bien - Krankenhaus Mara, Epilepsie-Zentrum, Bielefeld, Deutschland
  • Matthias Simon - Evangelisches Klinikum Bethel, Klinik für Neurochirurgie, Bielefeld, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocP221

doi: 10.3205/21dgnc503, urn:nbn:de:0183-21dgnc5031

Veröffentlicht: 4. Juni 2021

© 2021 Kalbhenn et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The number of patients requiring depth electrode implantation for invasive video EEG diagnostics increases in most epilepsy centres. Here we report on our institutional experience with frameless robot-assisted stereotactic placement of intracerebral depth electrodes using the Neuromate® stereotactic robot-system.

Methods: We identified all patients undergoing robot-assisted stereotactic placement of intracerebral depth electrodes for invasive extra-operative epilepsy monitoring between September 2013 and March 2020. We studied technical (placement) and diagnostic accuracy of the robot-assisted procedure, associated surgical complications and procedural time requirements.

Results: 464 depth electrodes were implanted in 74 patients (mean 6 per patient, range 1-12). There were 27 children and 47 adults (age range: 3.6–64.6 yrs.). The mean entry and target point errors were 1.82±1.15 and 1.98±1.05 mm. Target and entry point errors were significantly higher in paediatric vs. adult patients and for electrodes targeting the temporo-mesial region. There were no clinically relevant haemorrhages and no infectious complications. Mean time for the placement of one electrode was 37±14 min and surgery time per electrode decreased with the number of electrodes placed. 55 patients (74.3 %) underwent definitive surgical treatment. After a median follow-up of 24 (range 6-72) months 39/54 (72.2 %) patients were seizure-free (ILAE 1).

Conclusion: Frameless robot-guided stereotactic placement of depth electrodes with the Neuromate® stereotactic robot-system is safe and feasible even in very young children, with good in vivo accuracy and high diagnostic precision. The surgical workflow is time-efficient and further improves with increasing numbers of implanted electrodes.