J Korean Ster Func Neurosurg.  2023 Sep;19(2):42-50. 10.52662/jksfn.2023.00052.

Accuracy and safety of deep brain stimulation assisted by a neurosurgical robot attachable to the operating table

• Cheon S
• Jo I
• Youn J
• Cho JW
• Cho KR
• Lee JI

• KMID: 2546100
• DOI: http://doi.org/10.52662/jksfn.2023.00052

Abstract

Objective
Neurosurgical robots have recently been introduced to assist in guiding trajectories to achieve accurate targeting. This study investigated the accuracy of robot-assisted deep brain stimulation (DBS) compared with conventional DBS using the Leksell arc system.
Methods
Between October 2020 and September 2021, 29 patients underwent DBS using the Leksell arc system, while from October 2021 to August 2022, 20 patients underwent DBS using a neurosurgical robot system (KYMERO; Koh Young Technology). Radial errors, total operative time (surgery time, preparation time), and clinical outcomes were compared between both groups through a retrospective analysis.
Results
Radial errors were significantly smaller in robot-assisted DBS (1.63±0.39 mm vs. 1.01±0.39 mm, p<0.01). Furthermore, the error of the second implantation was smaller than in the Leksell DBS group (0.216 vs. 0.005 mm, p<0.001). The total operative time of DBS with Leksell frame was 3.47 hours (range, 2.38-5.85 hours) and the surgery time was 2.21 hours (range, 1.08-4.67 hours), while the total operative time in the robot group was 3.92 hours (range, 2.75-5.85 hours) and the surgical time was 2.60 hours (range, 1.02-4.67 hours) (p=0.055, p=0.258, respectively). The clinical outcome did not show a significant difference according to the surgical method.
Conclusion
DBS with a robot-assisted system enables the accurate and consistent insertion of DBS electrodes with a lower error rate than the conventional method.

Keyword

Deep brain stimulation; Movement disorders; Robotics; Stereotactic technique