Dr. Sumeet Vadera reviews scans before placing electrodes in an epilepsy patient's brain.
The traditional surgical approach to identifying and monitoring the source of epileptic seizures involved mounting an ungainly metal frame around the patient’s head that would guide the placement of sensitive electrodes deep in the brain.
While accurate, the frame is cumbersome. Neurosurgeon Dr. Sumeet Vadera and UCI Health colleagues share their experiences with a new technique that uses a robotic guidance system in two studies presented at the recent 2015 Congress of Neurological Surgeons annual meeting in New Orleans.
ROSA robotic guidance system
Likening it to “GPS for the brain,” Vadera says the ROSA robotic system offers a precise and simplified process for placing electrodes in the brain in order to identify the origin of epileptic seizures. UCI Health neurosurgeons used ROSA to guide the placement of electrodes in two different areas of the hippocampus region, which is located deep in the center of the brain.
The study findings were presented by Vadera and UCI Health colleagues Dr. Michelle Renee Paff, Dr. Catherine Christie and Dr. Frank Hsu.
“ROSA eliminates the need for a bulky, cumbersome metal headframe, which improves operating conditions for the surgeon with regards to patient positioning, and delivers the same level of accuracy as the traditional frame-based methods,” Vadera said.
Finding the seizures
In both studies, the entry points through the skull and planned pathways through the brain to reach the targeted areas were entered into the ROSA system, and CT scans were performed after surgery to confirm the placement accuracy of ROSA compared to frame-based methods.
“These studies show that we have created an advantageous technique for both bilateral and long axis depth electrode placement in the hippocampus,” Vadera said. “ROSA is an efficient method that comes with the added benefit of providing more comfortable operating conditions for the surgeon.”
In addition to surgery, the ROSA system can be adapted to guide the placement of electrodes for deep brain stimulation, a treatment for movement disorders like Parkinson’s disease, and minimally invasive procedures in which a laser incinerates brain lesions and tumors.
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