Stereotactic brain biopsy: evaluation of robot-assisted procedure in 60 patients
Frameless stereotactic biopsies, particularly robot-assisted procedures are increasing in neurosurgery centers. Results of these procedures should be at least equal to or greater than frame-based reference procedure. Evaluate robot-assisted technology is necessary in particular, when a team has chosen to switch from one to another method.
The objective of our prospective work was (i) to evaluate the success rate of contributive robotic-assisted biopsy in 60 patients, to report the morbidity and mortality associated with the procedure and (ii) to compare it with literature data.
We performed a prospective and descriptive study including 60 consecutive patients having had robotic-assisted stereotactic biopsy at the Rouen University Hospital, France. All patients had presurgical imaging before the procedure included Magnetic Resonance Imaging merged with Computed Tomography scan acquisition. Registration was mostly performed with a touch-free laser (57/60). A control Computed Tomography scan was always realized at day 0 or day 1 after surgery. Data collected were success rate, bleeding, clinical worsening, infection, and mortality.
All the biopsies were considered as contributive and lead to the final diagnosis. In 41/60 patients (68%), the lesion was glial. Six in 60 patients (10%) had visible bleeding without clinical worsening related, 5/60 patients (8.5%) showed clinical impairment following surgery, which was permanent in 2 patients, and 1/60 patient presented generalized seizures. We did not report any infection and mortality.
Robot-assisted frameless surgery is efficient and provides a reasonable alternative to frame-based procedure. The operating time can be reduced, without increasing morbidity and mortality rates.
KeywordsRobot assisted Stereotactic Biopsy Oncology Brain
The authors are grateful to Nikki Sabourin-Gibbs, Rouen University Hospital, for her help in editing the manuscript.
LT wrote the manuscript. VG was a major contributor in writing the manuscript. SD performed the surgeries and described and revised the manuscript. FM and MF supervised and revised the manuscript. All authors have read and approved the submitted manuscript.
Compliance with ethical standards
Conflict of interest
Authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Statement of informed consent
Informed consent was obtained from all individual participants included in the study.
- 6.Benabid AL, Cinquin P, Lavalle S, Le Bas JF, Demongeot J, De Rougemont J (1987) Computer-driven robot for stereotactic surgery connected to CT scan and magnetic resonance imaging: technological design and preliminary results. Appl Neurophysiol 50:153–154Google Scholar
- 9.Bernays RL, Kollias SS, Khan N, Brandner S, Meier S, Yo-nekawa Y (2002) Histological yield, complications, and technological considerations in 114 consecutive frameless stereotactic biopsy procedures aided by open intraoperative magnetic resonance imaging. J Neurosurg 97:354–362CrossRefGoogle Scholar
- 14.De Benedictis A, Trezza A, Carai A, Genovese E, Procaccini E, Messina R (2017) Robot-assisted procedures in pediatric neurosurgery. Neurosurg Focus E7:10.3171Google Scholar
- 19.Eljamel M (2008) Robotic applications in neurosurgery. Med Robots 1:1–24Google Scholar
- 22.Frank F, Fabrizi AP, Frank-Ricci R, Gaist G, Sedan R, Peragut GC (1988) Stereotactic biopsy and treatment of brain stem lesions: combined study of 33 cases (Bologna-Marseille). Acta Neurochir 42:177–181Google Scholar
- 23.Frank F, Fabrizi AP, Frank-Ricci R, Gaist G, Sédan R, Peragut JC (1988) Stereotactic biopsy and treatment of brainstem lesions: combined study of 33 cases (Bologna-Marseille). Acta Neurochir Suppl (Wien) 42:177–181Google Scholar
- 31.Guy G, Jan M, Guégan Y, Aubin ML, Fischer C, Ben-Hassel M (1989) Surgical lesions of the brain stem. Neurochirurgie 1(35):1–133Google Scholar
- 37.Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (2016) World Health Organization histological classification of tumours of the central nervous system 2016. International Agency for Research on Cancer, FranceGoogle Scholar
- 41.Regis J, Bouillot P, Rouby-Volot F, Figarella-Branger D, Dufour H, Peragut J (1996) Pineal region tumours and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases. Neurosurgery 39(5):907–914Google Scholar