Neurosurgery/Epilepsy Center

Robotic-assisted surgery for precise insertion of electrodes and needles into the brain

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Brain disorders such as epilepsy and brain tumors

Epilepsy is a brain disorder characterized by repeated seizures, where brain nerve cells become excited, leading to sudden loss of consciousness and convulsions in the limbs. Appropriate pharmacotherapy with antiepileptic drugs can control seizures in 70% of patients, but the remaining 30% have drug-resistant epilepsy, where seizures cannot be controlled by medication alone.

In cases where medication is ineffective, surgery can suppress or alleviate seizures. However, it is necessary to precisely determine the location of the epileptic focus in the brain. One method to identify the epileptic focus involves stereo-electroencephalography (SEEG), a procedure where multiple thin electrodes are implanted into the brain.

For brain tumors, treatment options include tumor resection, chemotherapy, and radiation therapy. Sometimes, a biopsy is performed to obtain a sample of the tumor to determine the treatment plan.

Cutting-edge neurosurgery with robotic assistance

Using a robotic system (Stealth Autoguide) (Fig. 1), procedures like SEEG, which is conducted to identify the epileptic focus, and biopsies, which aim to obtain a small part of the brain tumor, can be performed more safely and accurately.

Figure 1: Robotic System (©︎MEDTRONIC JAPAN CO., LTD.)

Surgical planning is based on preoperative CT and MRI images. Similar to a car navigation system that assists in driving, the navigation system helps precisely insert thin electrodes or needles to collect tumor samples into the brain.

The brain contains many blood vessels, and to avoid damaging them, the surgical plan confirms the absence of blood vessels along the route of the electrodes or needles before the surgery (Fig. 2).

Figure 2: Planned Electrode Placement Avoiding Brain Blood Vessels

Figure 3 shows an actual surgery scene. Additionally, using a much thinner drill to create holes in the skull results in smaller skin incisions, reducing the patient’s burden(Fig. 3).

Figure 3: The actual surgery

Written by
Yoshiteru Tada, M.D.

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