Robotized stereotactic assistant system for pediatric epilepsy and dystonia patients

XIE Zihang; XU Jinshan; FANG Tie; FANG Fang; ZHENG Lili; LI Hua; DENG Jie; CHEN Chunhong; WU Yun; WANG Xiaofei

Abstract：Objective The safety and efficacy of robotized stereotactic assistant system in pediatric patients were discussed.Methods From October 2016 to January 2017,24 pediatric patients required stereotactic surgery were treated with a robotic stereotactic assist system (ROSA).Pre-operative ROSA was used to set the electrode insertion point and target point.Intra-operative ROSA was used to determine the insertion point,direction and depth.After operation the safety and efficacy were evaluated.Results The average age of 24 children was 7.5 years (3 years ～16 years).The average medical history was 4 years (1 year ～9 years).A total of 210 deep electrodes were implanted including 13 cases undergoing unilateral implantation and 11 cases undergoing bilateral implantation,including 90 frontal lobes,68 temporal lobes,10 occipital lobes,26 parietal lobes,12 insular lobes,and 4 globus pallidus.The average implantation time of each electrode was less than 10 min.After the follow-up of CT and the pre-operative MRI fusion,it was found that the end of each electrode was basically consistent with the target location before implantation,and the average position error was 2.6 mm (0.3 ～ 5.9 mm).One patient had subarachnoid hemorrhage around the cranial bone at the site of the cranial bone and showed no signs of discomfort.There was no complication such as intracranial hematoma and electrode prolapse.Conclusion ROSA guided stereotactic implantation of deep intracranial electrodes in children can overcome the limitations of traditional frame stereotactic instrument in children,and it is safer,more accurate and convenient.