Comparison Of ROSA Robot And Traditional Framework For Deep Brain Stimulation Surgery

ObjectiveThis study compared the accuracy,precision,reliability,number of microelectrode penetrations during surgery,effective stimulation length,operation time,incidence of perioperative complications and safety between Deep Brain Stimulation surgeries for Subthalamic Nucleus(STN-DBS)guided by the ROSA robot-assisted system versus traditional frame-based stereotaxy.MethodsWe retrospectively analyzed 185 patients who underwent bilateral STN-DBS surgery at our center from november 2015 to june 2022.All patients were divided into two groups: the traditional frame-based stereotaxy group(n = 98),and the ROSA group(n = 87).Clinical and imaging data from both groups were analyzed and compared.ResultsFirstly,both the ROSA robot-assisted and traditional frame-based DBS methods have been shown to be highly accurate.The mean lateral deviation under ROSA guidance was 1.59 mm(SD: 0.71 mm,range: 0.13-3.23 mm),while the mean lateral deviation under traditional frame-based stereotaxy was 1.81 mm(SD: 0.81 mm,range:0.04-3.86 mm),with a statistically significant difference between them(P = 0.007).Secondly,DBS surgery guided by the ROSA robot significantly reduced the number of microelectrode penetrations during surgery compared to traditional frame-based stereotaxy(1.26 ± 0.87 vs.1.73 ± 1.18,P < 0.001),and significantly increased the effective stimulation length of the stn nucleus(5.87 ± 1.02 vs.5.44 ±0.98,P < 0.001).Finally,we found that the incidence of perioperative complications during DBS was slightly lower under the assistance of the ROSA robot(23.0%)than under traditional DBS surgery(31.6%),but there was no statistically significant difference between the two groups(P = 0.189 > 0.05).The mean operation time for ROSA-guided DBS(320.70 ± 67.74 min)was significantly longer than that of traditional electrode implantation(233.96 ± 51.53 min),with a statistical difference(P< 0.001).As the doctor’s learning curve grew,the later operation time(264.75 ± 65.19min)was significantly shorter than the initial experience with DBS under ROSA assistance(356.35 ± 71.06 min),showing a statistical significance(P < 0.001).ConclusionROSA robot-assisted surgery provides accuracy comparable to that based on the frame.Moreover,with the help of robots,we can obtain relatively strong signals of microelectrode recording(MER)with fewer penetrations,thereby reducing the occurrence of complications such as cerebral hemorrhage,improving patient comfort and increasing surgical efficiency.Therefore,ROSA robot-assisted surgery provides an appropriate and reliable alternative for neurosurgical stereotactic procedures.