Placement of Stereotactic Electroencephalography Depth Electrodes Using the Stealth Autoguide Robotic System: Technical Methods and Initial Results.
Journal
Operative neurosurgery (Hagerstown, Md.)
ISSN: 2332-4260
Titre abrégé: Oper Neurosurg (Hagerstown)
Pays: United States
ID NLM: 101635417
Informations de publication
Date de publication:
01 04 2022
01 04 2022
Historique:
received:
19
05
2021
accepted:
01
11
2021
entrez:
15
3
2022
pubmed:
16
3
2022
medline:
26
4
2022
Statut:
ppublish
Résumé
Robotic systems are gaining acceptance as a preferred tool for the placement of electrodes for stereotactic electroencephalography (SEEG) studies. To describe the technical methods for insertion of SEEG using the Medtronic Stealth Autoguide robotic system and detailed outcomes in the initial 9 patients implanted. Nine patients underwent placement of electrodes for SEEG studies with the use of the Autoguide system. Patients had at least 10 electrodes placed. Targets were planned on a Stealth S8 planning station, and electrodes were placed under general anesthesia. A technique for placement is described in detail. Patient outcomes and accuracy of electrode placement were evaluated. Methods to improve accuracy were investigated. Comparison of postoperative MRIs with preoperative planning MRIs was performed to determine the accuracy of electrode placement. One hundred two electrodes were placed in 9 patients. Methods for placement and technical nuances are detailed. The distance from the planned target to the actual position of the electrode tip was measured in 8 of the 9 patients. The mean Euclidean distance was 4.67 ± 0.27 mm. There was 1 placement-related hemorrhage deficit in the first patient, and no deaths or infections. Adequate positioning of electrodes for seizure monitoring was obtained in all patients. Autoguide can be used for placement of electrodes for SEEG studies with acceptable degrees of patient safety, accuracy, and efficiency. Considering the cost of Autoguide compared with other robotic devices, it may be attractive option.
Sections du résumé
BACKGROUND
Robotic systems are gaining acceptance as a preferred tool for the placement of electrodes for stereotactic electroencephalography (SEEG) studies.
OBJECTIVE
To describe the technical methods for insertion of SEEG using the Medtronic Stealth Autoguide robotic system and detailed outcomes in the initial 9 patients implanted.
METHODS
Nine patients underwent placement of electrodes for SEEG studies with the use of the Autoguide system. Patients had at least 10 electrodes placed. Targets were planned on a Stealth S8 planning station, and electrodes were placed under general anesthesia. A technique for placement is described in detail. Patient outcomes and accuracy of electrode placement were evaluated. Methods to improve accuracy were investigated. Comparison of postoperative MRIs with preoperative planning MRIs was performed to determine the accuracy of electrode placement.
RESULTS
One hundred two electrodes were placed in 9 patients. Methods for placement and technical nuances are detailed. The distance from the planned target to the actual position of the electrode tip was measured in 8 of the 9 patients. The mean Euclidean distance was 4.67 ± 0.27 mm. There was 1 placement-related hemorrhage deficit in the first patient, and no deaths or infections. Adequate positioning of electrodes for seizure monitoring was obtained in all patients.
CONCLUSION
Autoguide can be used for placement of electrodes for SEEG studies with acceptable degrees of patient safety, accuracy, and efficiency. Considering the cost of Autoguide compared with other robotic devices, it may be attractive option.
Identifiants
pubmed: 35289779
doi: 10.1227/ONS.0000000000000110
pii: 01787389-202204000-00012
pmc: PMC10602512
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e150-e157Subventions
Organisme : NINDS NIH HHS
ID : U01 NS117839
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © Congress of Neurological Surgeons 2022. All rights reserved.
Références
Children (Basel). 2020 Aug 07;7(8):
pubmed: 32784564
Stereotact Funct Neurosurg. 1993;60(4):210-4
pubmed: 8327800
Epilepsia. 2017 Jun;58(6):921-932
pubmed: 28261785
Neurochirurgie. 2017 Sep;63(4):286-290
pubmed: 28882607
Acta Neurochir (Wien). 2020 Oct;162(10):2527-2532
pubmed: 32458403
Seizure. 2016 Oct;41:191-5
pubmed: 27131772
Epilepsia. 2016 Mar;57(3):386-401
pubmed: 26899389
Stereotact Funct Neurosurg. 2018;96(5):311-319
pubmed: 30326475
J Neurosurg. 2014 Nov;121(5):1239-46
pubmed: 25148007
Oper Neurosurg (Hagerstown). 2018 Sep 1;15(3):292-295
pubmed: 29228338
J Neurosurg. 2020 Aug 14;135(1):245-254
pubmed: 32796145
Electroencephalogr Clin Neurophysiol. 1987 Jun;66(6):467-82
pubmed: 2438112
J Neurosurg Pediatr. 2017 Oct;20(4):364-370
pubmed: 28777037
Neurol Med Chir (Tokyo). 2017 Aug 15;57(8):375-385
pubmed: 28637943
J Neurosurg Pediatr. 2018 Nov 1;22(5):1-8
pubmed: 30117789
Neurosurgery. 2013 Mar;72(3):353-66; discussion 366
pubmed: 23168681
Neurosurg Focus. 2017 May;42(5):E7
pubmed: 28463617
Neurosurgery. 2011 Mar;68(1 Suppl Operative):114-24; discussion 124
pubmed: 21206322
Oper Neurosurg (Hagerstown). 2018 Sep 1;15(3):302-309
pubmed: 28961938
Electroencephalogr Clin Neurophysiol. 1976 Mar;40(3):225-43
pubmed: 57852