Postoperative intracerebral haematomas following stereotactic biopsies: Poor planning or poor execution?
computer-assisted
haematoma
image processing
robotic surgical procedures
stereotactic biopsy
Journal
The international journal of medical robotics + computer assisted surgery : MRCAS
ISSN: 1478-596X
Titre abrégé: Int J Med Robot
Pays: England
ID NLM: 101250764
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
03
08
2020
revised:
14
11
2020
accepted:
15
12
2020
pubmed:
22
12
2020
medline:
21
7
2021
entrez:
21
12
2020
Statut:
ppublish
Résumé
Postoperative intracerebral haematomas represent a serious complication following stereotactic biopsy. We investigated the possible underlying causes - poor planning or poor execution - of postoperative intracerebral haematomas following stereotactic biopsies. We performed a technical investigation using a retrospective single-centre consecutive series of robot-assisted stereotactic biopsies for a supratentorial diffuse glioma in adults. Each actual biopsy trajectory was reviewed to search for a conflict with an anatomical structure at risk. From 379 patients, 12 (3.2%) presented with a postoperative intracerebral haematoma ≥20 mm on postoperative CT-scan (3 requiring surgical evacuation); 11 of them had available intraoperative imaging (bi-planar stereoscopic teleangiography x-rays at each biopsy site). The actual biopsy trajectory was similar to the planned biopsy trajectory in these 11 cases. In 72.7% (8/11) of these cases, the actual biopsy trajectory was found to contact a structure at risk (blood vessel and cerebral sulcus) and identified as the intracerebral haematoma origin. Robot-assisted stereotactic biopsy is an accurate procedure. Postoperative intracerebral haematomas mainly derive from human-related errors during trajectory planning.
Sections du résumé
BACKGROUND
BACKGROUND
Postoperative intracerebral haematomas represent a serious complication following stereotactic biopsy. We investigated the possible underlying causes - poor planning or poor execution - of postoperative intracerebral haematomas following stereotactic biopsies.
METHODS
METHODS
We performed a technical investigation using a retrospective single-centre consecutive series of robot-assisted stereotactic biopsies for a supratentorial diffuse glioma in adults. Each actual biopsy trajectory was reviewed to search for a conflict with an anatomical structure at risk.
RESULTS
RESULTS
From 379 patients, 12 (3.2%) presented with a postoperative intracerebral haematoma ≥20 mm on postoperative CT-scan (3 requiring surgical evacuation); 11 of them had available intraoperative imaging (bi-planar stereoscopic teleangiography x-rays at each biopsy site). The actual biopsy trajectory was similar to the planned biopsy trajectory in these 11 cases. In 72.7% (8/11) of these cases, the actual biopsy trajectory was found to contact a structure at risk (blood vessel and cerebral sulcus) and identified as the intracerebral haematoma origin.
CONCLUSIONS
CONCLUSIONS
Robot-assisted stereotactic biopsy is an accurate procedure. Postoperative intracerebral haematomas mainly derive from human-related errors during trajectory planning.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e2211Informations de copyright
© 2021 John Wiley & Sons Ltd.
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