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Neuro-oncology application of next-generation, optically tracked robotic stereotaxis with intraoperative computed tomography: a pilot experience
Journal article   Open access   Peer reviewed

Neuro-oncology application of next-generation, optically tracked robotic stereotaxis with intraoperative computed tomography: a pilot experience

Carlin Chuck, Rohaid Ali, Christine K Lee, Athar N Malik, Konstantina A Svokos, Deus Cielo, Curtis E Doberstein, Harry J Rosenberg, Jerrold L Boxerman, Joseph Rajasekaran, …
Neurosurgical focus, v 57(6), E4
01 Dec 2024
PMID: 39616644
url
https://doi.org/10.3171/2024.9.FOCUS24532View
Published, Version of Record (VoR) Open

Abstract

Adult Aged Brain Neoplasms - diagnostic imaging Brain Neoplasms - surgery Female Humans Male Middle Aged Neurosurgical Procedures - methods Pilot Projects Retrospective Studies Robotic Surgical Procedures - methods Stereotaxic Techniques Tomography, X-Ray Computed - methods
Innovations in robotics continue to reshape the landscape of neurosurgery. Here, the authors evaluated the safety and efficacy of the ExcelsiusGPS robot in the treatment of neuro-oncological, intracranial lesions. The authors conducted a retrospective analysis of 19 consecutive adult patients with a neuro-oncological diagnosis who underwent intracranial biopsy and/or laser interstitial thermal therapy (LITT) with the assistance of the ExcelsiusGPS robot and intraoperative CT. Demographic and clinical data were collected from the electronic medical record and the robot software. All 19 patients harbored lesions that were deep seated, involving the eloquent cortex, or subcentimeter. Definitive tissue diagnosis was achieved in all cases involving stereotactic biopsy (n = 16), with glioblastoma as the most common diagnosis. The mean ± SD time for setting up the robotic stereotaxis system was 57.4 ± 10.7 minutes. The mean procedural time after that was 71.6 ± 41.0 minutes for stereotactic needle biopsy and 188.4 ± 61.2 minutes for procedures involving LITT. The mean radial errors of the actual trajectory relative to the planned trajectory at the entry and target points were 0.625 ± 0.443 mm and 0.745 ± 0.472 mm, respectively. There were no procedural complications or new postoperative deficits, although routine postoperative CT showed new hyperdensity at the target site in 3/19 patients (15.7%). All patients who underwent elective procedures were discharged by postoperative day 3 (mean 1.38 ± 0.619 days). There were two 30-day readmissions (pulmonary embolus and general weakness), and neither was attributable to the surgical procedure. The authors' pilot experience with the ExcelsiusGPS robot in neuro-oncology procedures indicates a favorable efficacy and safety profile.

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Surgery
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