Robotic implantation of deep brain stimulation leads, assisted by intra-operative, flat-panel CT.

Abstract

There are two mandatory skills in deep brain stimulation (DBS) neurosurgery: accuracy and control. Frame-based robotic registration was performed. Prior to insertion into the skull, the guide tube's position was checked with flat-panel computed tomography (fpCT). After registration against the pre-operative plan, we measured and corrected the robotic arm's position so that the guide tube with the micro-electrode would follow the planned trajectory exactly. We then used fpCT again to check the DBS lead's final position. The combination of intra-operative fpCT with robotised surgery provides an appropriate, user-friendly solution to the key technical challenges in DBS lead implantation.