Abstract
Background Stereoelectroencephalography (SEEG) electrodes are implanted using a variety of stereotactic
technologies to treat refractory epilepsy. The value of the SINO robot for SEEG electrode
implantation is not yet defined. The aim of the current study was to assess the value
of the SINO robot in conjunction with Angio Render technology for SEEG electrode implantation
and to assess its efficacy.
Methods Between June 2018 and October 2020, 58 patients underwent SEEG electrode implantation
to resect or ablate their epileptogenic zone (EZ). The SINO robot and the Angio Render
technology was used to guide the electrodes and visualize the individual vasculature
in a three-dimensional (3D) fashion. The 3D view functionality was used to increase
the safety and accuracy of the electrode implantation, and for reducing the risk of
hemorrhage by avoiding blood vessels.
Results In this study, 634 SEEG electrodes were implanted in 58 patients, with a mean of
10.92 (range: 5–18) leads per patient. The mean entry point localization error (EPLE)
was 0.94 ± 0.23 mm (range: 0.39–1.63 mm), and the mean target point localization error
(TPLE) was 1.49 ± 0.37 mm (range: 0.80–2.78 mm). The mean operating time per lead
(MOTPL) was 6. 18 ± 1.80 minutes (range: 3.02–14.61 minutes). The mean depth of electrodes
was 56.96 ± 3.62 mm (range: 27.23–124.85 mm). At a follow-up of at least 1 year, in
total, 81.57% (47/58) patients achieved an Engel class I seizure freedom. There were
two patients with asymptomatic intracerebral hematomas following SEEG electrode placement,
with no late complications or mortality in this cohort.
Conclusions The SINO robot in conjunction with Angio Render technology-in SEEG electrode implantation
is safe and accurate in mitigating the risk of intracranial hemorrhage in patients
suffering from drug-resistant epilepsy.
Keywords
SINO robot - Angio Render technology - vessel visualization - stereoelectroencephalography
- drug-resistant epilepsy
