Robot-Assisted Percutaneous Balloon Compression for Trigeminal Neuralgia: Technique Description and Short-Term Clinical Results

Frontiers in Surgery

article

Qiangqiang Liu¹  Junjie Wang²  Changquan Wang²  Wenze Chen²  Wenzhen Chen¹  Xiaolai Ye¹  Ziyu Mao²  Chencheng Zhang³  Jiwen Xu¹ 

[1] Department of Neurosurgery, Clinical Neuroscience Center Comprehensive Epilepsy Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine;Clinical Neuroscience Center, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine;Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine;Shanghai Research Center for Brain Science and Brain-Inspired Technology

关键词: trigeminal neuralgia;    percutaneous balloon compression;    robotics;    stereotactic neurosurgery;    technique;   

DOI  :  10.3389/fsurg.2022.869223

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective Percutaneous balloon compression (PBC) is a minimally invasive treatment for trigeminal neuralgia (TG) with a favorable cost-effectiveness ratio, but this technique has a steep learning curve. This study presents our initial clinical experience of robot-assisted PBC using a neurosurgical robot on six consecutive patients with TG. Methods We fixed the patient's head with a skull clamp and connected it with the linkage arms of a Sinovation ® neurosurgical robot, which was then registered using four bone fiducials by the robotic pointer. The puncture needle was positioned at the entry point on the skin using a robotic arm and advanced to the target point after the skin had been incised with a pointed surgical blade. This procedure was repeated for a second trajectory. A balloon was then advanced and inflated using 0.3 ml of a contrast agent. Upon injection of 0.6 ml contrast agent, the ganglion was kept compressed for 120 s. After removal of the balloon and puncture needle, compression of the face was performed to achieve hemostasis. Results All patients achieved immediate pain relief following PBC. No permanent or severe complications were registered, and there was no pain recurrence in any of the patients during the follow-up period. Conclusions Despite requiring a longer time for preoperative preparation, robot-assisted PBC provided a high degree of accuracy and safety, and it can also shorten the learning curve for surgeons unfamiliar with PBC. Robot-assisted surgical approaches should be further developed and adopted for PBC.

【 授权许可】

CC BY