المتخصصون في المجالات الطبية

Aug. 26, 2023

Mayo Clinic has the expertise and technology needed to perform complex functional neurosurgeries. A robotic system, which is standardized across the three main campuses, can increase the accuracy and efficiency of these procedures.

"The robotic system is transformative. It allows us to tackle more-challenging cases of epilepsy and movement disorder that require complex implantations of electrodes," says Jonathan J. Parker, M.D., Ph.D., a neurosurgeon at Mayo Clinic in Phoenix/Scottsdale, Arizona.

The system can be used to perform several types of functional neurosurgery, including laser ablation and electrode implantation for deep brain stimulation and responsive neurostimulation. In addition to epilepsy, specific conditions that can be managed with the robotic system include essential tremor, Parkinson's disease, dystonia, tumors and radiation necrosis.

"Mayo Clinic has selected the most accurate robotic system available," says Jamie J. Van Gompel, M.D., a neurosurgeon at Mayo Clinic in Rochester, Minnesota. "As an enterprise, we have the busiest brain stimulation program in the United States. The robotic system allows us to do the extensive implantations that tailor therapies to individual patients' needs."

'An ultrastable arm'

Mayo Clinic specialists routinely perform complex functional neurosurgery that involves modulating several sites in the brain simultaneously.

"Doing that without a robotic system can be technically cumbersome," Dr. Parker says. "Measurement errors can occur when numbers are manually set on stereotactic head frames. Robotic systems avoid that potential for human error."

The robotic system helps neurosurgeons to position electrodes accurately while avoiding blood vessels. "It minimizes not only target error but also entry point error," says Sanjeet S. Grewal, M.D., a neurosurgeon at Mayo Clinic in Jacksonville, Florida.

The robotic system enhances accuracy even in areas of the brain where surgical approach is challenging.

"The robot allows us to contour laser ablations more precisely for treatments that involve multiple trajectories when we are targeting thin structures deep in the brain for epilepsy surgery," says Kai J. Miller, M.D., Ph.D., a neurosurgeon at Mayo Clinic's campus in Minnesota. "We will be able to maintain the highest level of precision even when coming from difficult angles — approaches that haven't been possible with our existing techniques. This is particularly relevant for surgeries like brain stem biopsies."

Operating times also can be shortened. "The patient spends less time under anesthesia and has a quicker recovery," Dr. Parker says.

Individuals might need counseling about the exact nature of robotic surgery. "Patients often think that a robot is doing the surgery on its own — that it's coming up with its own thoughts on where to place the electrode," Dr. Parker says. "But the system isn't autonomous. It's like an ultrastable arm for physicians. We control where it goes, but that arm is much more fluid and precise than a surgeon's hand could ever be."

Potential future applications include endoscopic procedures and the delivery of regenerative therapies that avoid the need for surgery. "We could use the robotic system to deliver gene or cellular therapies, or other medications. The possibilities are exciting," Dr. Grewal says.

For now, the use of a state-of-the-art system enterprisewide underlines Mayo Clinic's commitment to optimal management of complex neuromodulations. "The robotic system enhances our ability to offer this care to more patients with greater efficiency and safety," Dr. Parker says.

For more information

Refer a patient to Mayo Clinic.