Preliminary communication

https://doi.org/10.20471/acc.2021.60.02.17

The Safety and Efficacy of Robot-Assisted Stereotactic Biopsy for Brain Glioma: Earliest Institutional Experiences and Evaluation of Literature

Krešimir Rotim ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia
Bruno Splavski orcid.org/0000-0002-4483-9364 ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; University of Applied Health Sciences, Zagreb, Croatia; Josip Juraj Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Osijek, Croatia
Filip Vrban ; Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia

Abstract

Robot-assisted brain tumor biopsy is becoming one of the most important innovative
technologies in neurosurgical practice. The idea behind its engagement is to advance the safety
and efficacy of the biopsy procedure, which is much in demand when planning the management of
endocranial tumor pathology. Herein, we provide our earliest institutional experiences in utilizing this
mesmerizing technology. Cranial robotic device was employed for stereotactic robot-assisted brain
glioma biopsy in three consecutive patients from our series: an anaplastic isocitrate dehydrogenase
(IDH) negative astrocytoma (WHO grade III) located in the right trigone region of the periventricular
white matter; a low grade diffuse astrocytoma (WHO grade II) of bilateral thalamic region
spreading into the right mesencephalic area; and an IDH-wildtype glioblastoma (WHO grade IV) of
the right frontal lobe producing a contralateral midline shifting. Robot-assisted tumor biopsy was
successfully performed to get tissue samples for histopathologic and immunohistochemical analysis.
The adjacent tissue iatrogenic damage of the eloquent cortical areas was minimal, while the immediate
postoperative recovery was satisfactory in all patients. In conclusion, considering the preliminary results
of our early experiences, robot-assisted tumor biopsy was proven to be a feasible and accurate
procedure when surgery for brain glioma was not an option. It may increase safety and precision,
without expanding surgical time, being similarly effective when compared to standard stereotactic and
manual biopsy. Using this method to provide accurate sampling for histopathologic and immunohistochemical
analysis is a safe and easy way to determine management strategies and outcome of different
types of brain glioma.

Keywords

Neurosurgery; Brain glioma; Robotics; Stereotactic biopsy

Hrčak ID:

263755

URI

https://hrcak.srce.hr/263755

Publication date:

1.6.2021.

Article data in other languages: croatian

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