Neurosurgeons from the London Health Sciences Centre (LHSC) have successfully performed deep brain stimulation surgery with the help of a robot.
Across Canada, it’s the first time a robot has been used to assist in this procedure.
The Renishaw neuromate® robot was donated to University Hospital by the London Health Sciences Foundation in 2017. It has already been used by Dr. Jonathan Lau, assistant professor of Neurosurgery at Western University, in robotic-assisted stereoelectroencephalography (SEEG) procedures. SEEG is used to map activity in the brain for patients with complex cases of epilepsy.
LHSC says an estimated 1 in 100 people suffer from this neurological condition.
Epilepsy is a brain disorder marked by repeated seizures. In severe cases, patients can have upwards of 12 seizures a day. Also, about 30 per cent of epilepsy cases are drug-resistant, according to LHSC.
Deep brain simulation surgery, Dr. Lau says, is a treatment that uses a pacemaker to restore normal brain rhythms, therefore reducing the number of seizures an epileptic person experiences.
The procedure involves placing small electrodes – one to two millimetres in diameter – about 10 to 15 centimetres deep inside the brain.
A Renishaw neuromate® robot assists with deep brain simulation surgery. Screen capture from video provided by LHSC.
Traditionally, the process of creating small holes in the skull and inserting electrodes into brain tissue comes with some serious risks.
“One of the main advantages of the robot is it removes the potential for some degrees of human error,” said Dr. Lau.
So far this year, the Renishaw neuromate® has assisted in three procedures, and all have gone well from a safety perspective. Patients can typically be sent home in just one day.
“The robot allows accurate, individualized trajectories and can quickly move between electrode implants with minimal manual intervention,” Dr. Lau explained.
So far, the results are promising. While deep brain stimulation surgery isn’t a cure for epilepsy, studies are demonstrating that the procedure can reduce the frequency of seizures by about 50 per cent.
Reducing a patient’s seizures can do a lot to improve their quality of life, according to Dr. David Steven, a neurosurgeon at University Hospital and chair of the Department of Clinical Neurological Sciences at Western’s Schulich School of Medicine and Dentistry.
“By the time we see them, the seizures, or the fact that they might have a seizure, gets in the way of their everyday life,” says Dr. Steven, “Additional medications or changing medications rarely is successful. For some patients, this is an extremely effective treatment and reduces their seizures by a very significant amount.”
Deep brain stimulation surgery has also been used to treat other conditions such as Parkinson’s disease, tremors, and even obsessive-compulsive disorder.
“This is a significant development that provides a new option using a surgical robot for accurately placing brain pacemaker electrodes across a wide range of neurological disorders,” Dr. Lau said.
