Pushing the boundaries of accuracy and reliability during stereotactic procedures: A prospective study on 526 biopsies comparing the frameless robotic and Image-Guided Surgery systems. (January 2022)

• Record Type: Journal Article
• Authors: Mallereau, Charles-Henry; Chibbaro, Salvatore; Ganau, Mario; Benmekhbi, Mustapha; Cebula, Helene; Dannhoff, Guillaume; Santin, Marie-des-Neiges; Ollivier, Irène; Chaussemy, Dominique; Hugo Coca, Andres; Proust, François; Todeschi, Julien
• Is Part Of: Journal of clinical neuroscience. Volume 95(2022)
• Page Start: 203
• Page End: 212
• Publication Date: 2022-01
• Subjects: GCS Glasgow Coma Scale -- IGS Image-Guided Surgery; Robotic surgical procedures -- Stereotactic biopsy -- Robotic device -- Stereotactic neurosurgery; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2021.11.034
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Robotic assisted biopsy lives up to its promises of increased safety, accuracy and reliability. Robotic assisted biopsy allows a high diagnostic rate up to 97, 4%. Robotic biopsy has a very low hemorrhagic complication rate (3, 5 %) with no permanent deficit. Robotic assisted biopsy has very low mortality rate (0, 3%). Learning curve for Robotic biopsy is relatively short with a cut off of 10 procedures to get acquainted. Abstract: Introduction: A 12-year long, prospective, single center study was conducted, comparing two frameless systems for brain biopsies: ROSA robotic-assisted stereotaxy and BrainLab Varioguide image-guided stereotaxy (Image Guided Surgery, IGS). Method: All consecutive adult and pediatric patients undergoing frameless brain biopsies were included. Successfully achieving diagnosis was the primary endpoint, analysis of all periprocedural complications was the secondary endpoint, and the tertiary endpoint was the length of the procedure, with the aim of assessing of the learning curve for each operator over time. The results for the ROSA robot and the Varioguide system were compared and benchmarked to data from the literature. Results: We performed 526 on 516 patients, 314 with the ROSA robot (Group A) and 212 with the IGS Varioguide (Group B). Histological diagnosis was achieved in 97.4% of cases in Group A, versus 93.3% in Group B (p < 0.05). No statistically significant difference was found for secondary and tertiary endpoints. The complication rate appeared similar between the 2 frameless systems, with a hemorrhagic complications rate of 3.5% in Group A and 4.7% in Group B. Permanent neurological deterioration was only recorded in 0.8% of cases from Group B. Mortality was recorded in 0.3% in Group A and 0.4% in Group B. Conclusion: This study provides evidence to confirm that robotic surgery lives up to its promises of increased safety, accuracy, and reliability.