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Comparison of Robotic and Manual Implantation of Intracerebral Electrodes: A Single-Centre, Single-Blinded, Randomised Controlled Trial

Vakharia, V; Rodionov, R; Miserocchi, A; McEvoy, A; O'Keeffe, A; Granados, A; Shapoori, S; ... Duncan, J; + view all (2021) Comparison of Robotic and Manual Implantation of Intracerebral Electrodes: A Single-Centre, Single-Blinded, Randomised Controlled Trial. Research Square Green open access

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Abstract

There has been a significant rise in robotic trajectory guidance devices that have been utilised for stereotactic neurosurgical procedures. These devices have significant costs and associated learning curves. Previous studies reporting devices usage have not undertaken prospective parallel-group comparisons before their introduction, so the comparative differences are unknown.We study the difference in stereoelectroencephalography electrode implantation time between a robotic trajectory guidance device (iSYS1) and manual frameless implantation (PAD) in patients with drug-refractory focal epilepsy through a single-blinded randomised control parallel-group investigation of SEEG electrode implantation, concordant with CONSORT statement.Thirty-two patients (18 male) completed the trial. The iSYS1 returned significantly shorter median operative time for intracranial bolt insertion, 6.36 min (95%CI 5.72-7.07) versus 9.06 min (95%CI 8.16- 10.06), ratio of median estimate (iSYS1/PAD) 0.70 (95%CI 0.61-0.81), p=0.0001. The PAD group had a better median target point accuracy 1.58 mm (95%CI 1.38- 1.82) versus 1.16 mm (95%CI 1.01- 1.33)), p=0.004. The mean electrode implantation angle error was 2.13 o for the iSYS1 group and 1.71 o for the PAD groups (p=0.023). There was no statistically significant difference for any other outcome.Health policy and hospital commissioners should consider these differences in the context of the opportunity cost of introducing robotic devices.Trial registration: ISRCTN17209025 (https://doi.org/10.1186/ISRCTN17209025)

Type: Working / discussion paper
Title: Comparison of Robotic and Manual Implantation of Intracerebral Electrodes: A Single-Centre, Single-Blinded, Randomised Controlled Trial
Open access status: An open access version is available from UCL Discovery
DOI: 10.21203/rs.3.rs-461201/v1
Publisher version: https://doi.org/10.21203/rs.3.rs-461201/v1
Language: English
Additional information: This work is licensed under a CC BY 4.0 License.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10132745
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