Robot-assisted versus manual frame-based stereoelectroencephalography

Abstract

OBJECTIVE: The aim of this study was to retrospectively compare robot-assisted and manual frame-based stereoelectroencephalography (SEEG) with respect to timing, complications, and outcomes in a high-volume epilepsy surgery center. METHODS: All patients with drug-resistant epilepsy who underwent SEEG from 2000 to 2020 were collected for a retrospective-and from 2017 onward, prospective-database. RESULTS: A total of 192 SEEG procedures consisted of 88 robot-assisted and 104 manual frame-based cases. Both groups were of similar age, gender distribution, and duration of epilepsy. A mean of 10.9 electrodes were implanted for the robot-assisted group versus 9.3 electrodes in the manual frame-based group (p < 0.01) with a mean implantation time per electrode of 8.2 ± 3.4 versus 16.1 ± 7.7 minutes, respectively (p < 0.01). Complications were low in both groups; intracranial hemorrhage was observed in 6.8% and 5.8%, respectively. CONCLUSIONS: Using a stereotactic robot for SEEG electrode insertion can significantly decrease operative time.