Abstract

Background: The Ommaya reservoir implantation technique allows for bypass of the blood-brain barrier. It can be continuously administered locally and be used to repeatedly flush the intracranial cavity to achieve the purpose of treatment. Accurate, fast, and minimally invasive placement of the drainage tube is essential during the Ommaya reservoir implantation technique, which can be achieved with the assistance of robots.Methods: We retrospectively analyzed a total of 100 patients undergoing Ommaya reservoir implantation, of which 50 were implanted using a robot, and the remaining 50 were implanted using conventional surgical methods. We then compared the data related to surgery between the two groups and calculated the accuracy of the drainage tube of the robot-assisted group.Results: The average operation time of robot-assisted surgery groups was 41.17 ± 11.09 min, the bone hole diameter was 4.1 ± 0.5 mm, the intraoperative blood loss was 11.1 ± 3.08 ml, and the average hospitalization time was 3.9 ± 1.2 days. All of the Ommaya reservoirs were successful in one pass, and there were no complications such as infection or incorrect placement of the tube. In the conventional Ommaya reservoir implantation group, the average operation time was 65 ± 14.32 min, the bone hole diameter was 11.3 ± 0.3 mm, the intraoperative blood loss was 19.9 ± 3.98 ml, and the average hospitalization time was 4.1 ± 0.5 days. In the robot-assisted surgery group, the radial error was 2.14 ± 0.99 mm and the axial error was 1.69 ± 1.24 mm.Conclusions: Robot-assisted stereotactic Ommaya reservoir implantation is quick, effective, and minimally invasive. The technique effectively negates the inefficiencies of craniotomy and provides a novel treatment for intracranial lesions.

Highlights

  • Intracranial space-occupying lesions, especially those with large space-occupying volume and those located in important functional areas, are difficult to remove completely, and result in high recurrence and poor prognosis in patients

  • The process of placing the drainage tube operated under nondirect vision was investigated, with results indicating several complications, including intraoperative intracranial hemorrhage, infection and incorrect placement of the drainage tube

  • The neurosurgical robot offers the advantages of accuracy, stability, and safety, which can meet the needs of Ommaya reservoir implantation

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Summary

Introduction

Intracranial space-occupying lesions, especially those with large space-occupying volume and those located in important functional areas, are difficult to remove completely, and result in high recurrence and poor prognosis in patients. One of the main functions of the Ommaya reservoir is to enable drugs to directly bypass the blood-brain barrier for intraventricular administration, reduce intracranial hypertension, and improve the symptoms of increased intracranial pressure. With the help of navigation (Wang A. et al, 2019), catheterization can be located accurately in real time, so as to avoid damage to important brain tissues and blood vessels, and improve the accuracy and safety of neurosurgery. The Ommaya reservoir implantation technique allows for bypass of the blood-brain barrier. It can be continuously administered locally and be used to repeatedly flush the intracranial cavity to achieve the purpose of treatment. Fast, and minimally invasive placement of the drainage tube is essential during the Ommaya reservoir implantation technique, which can be achieved with the assistance of robots

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