Usefulness of Robotic Stereotactic Assistance (ROSA ^® ) Device for Stereoelectroencephalography Electrode Implantation: A Systematic Review and Meta-analysis.

Publisher: Japan Neurosurgical Society Country of Publication: Japan NLM ID: 0400775 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1349-8029 (Electronic) Linking ISSN: 04708105 NLM ISO Abbreviation: Neurol Med Chir (Tokyo)

Original Publication: Tokyo : Japan Neurosurgical Society.

Electrodes, Implanted* ; Robotic Surgical Procedures*/instrumentation ; Stereotaxic Techniques* ; Electroencephalography*/instrumentation ; Drug Resistant Epilepsy*/surgery; Humans

The aim of this study was to systematically review and meta-analyze the efficiency and safety of using the Robotic Stereotactic Assistance (ROSA ^® ) device (Zimmer Biomet; Warsaw, IN, USA) for stereoelectroencephalography (SEEG) electrode implantation in patients with drug-resistant epilepsy. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was carried out. Overall, 855 nonduplicate relevant articles were determined, and 15 of them were selected for analysis. The benefits of the ROSA ^® device use in terms of electrode placement accuracy, as well as operative time length, perioperative complications, and seizure outcomes, were evaluated. Studies that were included reported on a total of 11,257 SEEG electrode implantations. The limited number of comparative studies hindered the comprehensive evaluation of the electrode implantation accuracy. Compared with frame-based or navigation-assisted techniques, ROSA ^® -assisted SEEG electrode implantation provided significant benefits for reduction of both overall operative time (mean difference [MD], -63.45 min; 95% confidence interval [CI] from -88.73 to -38.17 min; P < 0.00001) and operative time per implanted electrode (MD, -8.79 min; 95% CI from -14.37 to -3.21 min; P = 0.002). No significant differences existed in perioperative complications and seizure outcomes after the application of the ROSA ^® device and other techniques for electrode implantation. To conclude, the available evidence shows that the ROSA ^® device is an effective and safe surgical tool for trajectory-guided SEEG electrode implantation in patients with drug-resistant epilepsy, offering benefits for saving operative time and neither increasing the risk of perioperative complications nor negatively impacting seizure outcomes.

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Keywords: Robotic Stereotactic Assistance (ROSA®); depth electrode implantation; efficacy; epilepsy; stereoelectroencephalography

Date Created: 20240114 Date Completed: 20240807 Latest Revision: 20240819

20250114

PMC10918457

10.2176/jns-nmc.2023-0119

38220166