gms | German Medical Science

71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

Article

Send article

Safety and time efficiency of robot-guided surgery versus classic frame-based stereotaxy

Sicherheit und Operationsdauer – roboterassistierte Serienbiopsie und klassische Stereotaxie im Vergleich

Meeting Abstract

Search Medline for

  • presenting/speaker Andrea Spyrantis - Johann Wolfgang Goethe-Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Johanna Quick-Weller - Johann Wolfgang Goethe-Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Adriano Cattani - Johann Wolfgang Goethe-Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Laurent Willems - Johann Wolfgang Goethe-Universität Frankfurt am Main, Neurologie, Frankfurt am Main, Deutschland
  • Tirza Woebbecke - Johann Wolfgang Goethe-Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Anne Constantinescu - Johann Wolfgang Goethe-Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Volker Seifert - Johann Wolfgang Goethe-Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Thomas Freiman - Johann Wolfgang Goethe-Universität Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP152

doi: 10.3205/20dgnc436, urn:nbn:de:0183-20dgnc4368

Published: June 26, 2020

© 2020 Spyrantis 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

Text

Objective: With the introduction of the robotic surgery assistant (ROSA) in our department in 2015, we have acquired an alternative to classic stereotactic surgery. In this study, we compare robot-assisted and stereotactic biopsies regarding safety and time efficiency for different intracranial target areas.

Methods: All patients who underwent guided biopsy from 01/2015 to 12/2018 were included, 148 patients had ROSA guided surgery, 258 patients were operated using the Leksell stereotactic frame. Referencing was carried out by a laser-scan of the face for the ROSA system and by thin-layer computer tomography (CT) for the Leksell frame.

Results: We performed 151 robot-guided biopsies in 148 patients. We identified 10 postoperative hemorrhages, 5 of them clinically silent. In 5 patients, neurological deficits due to postoperative hemorrhages were diagnosed (3%). The average overall procedure time including anesthesia was 169 min. With the Leksell frame, 266 stereotactic biopsies in 258 patients were performed. Complications included 20 postoperative hemorrhages, 8 of them relevant (3%). Seizures occurred in 2 patients (< 1%) and wound infections in 3 patients (1%). The average time was significantly longer and amounted to 179 min (p = 0,01). Particularly interesting was the fact that robot-guided surgery required significantly less time in the biopsy of temporal targets (161 min, n = 25) than stereotactic surgery (188 min, n = 39), p < 0,001.

Conclusion: The procedure time could be shortened by using the ROSA system, in particular in temporal biopsies. The time saving is most likely due to the sparing of the transport to the thin-layer CT and its fusion. In particular, temporal biopsies are difficult to plan due to the positioning of the frame, which shall not interfere with the biopsy trajectory.