ROSA to the Occasion: Epilepsy Care Gets Robotic Boost at UC San Diego Health

Newswise — Neurosurgery is among the many most difficult branches of surgical procedure. The human mind, with its estimated 100 billion neurons and 100 trillion connections, is arguably probably the most complicated organic construction identified, and surgeons should typically function inside the slim confines of the mind, spinal twine and nervous system.

Generally it’s good to have one other set of “palms,” a ROSA by one other identify.

ROSA is brief for Robotic Stereotactic Help, and inside the Division of Neurosurgery at UC San Diego Well being, the modern expertise is at hand.

Of the numerous procedures during which ROSA can help, it shines maybe brightest throughout stereotactic electroencephalography (sEEG), an intracranial monitoring process during which 10 to twenty skinny electrodes (lower than 1 millimeter in diameter, concerning the thickness of a bank card) are inserted into the mind to exactly map the places from which epileptic seizures emanate.

Sharona Ben-Haim, MD, the UC San Diego Well being neurosurgeon who launched sEEG to the San Diego area 5 years in the past, calls the process “a lot quicker and safer now, and with the effectivity and accuracy that solely a robotic platform can present.”

Sage Magaña, 18, not too long ago underwent the ROSA-assisted process. Two years in the past, she was recognized with frontal lobe epilepsy, with a typical day interrupted by as much as 5 seizures lasting for as a lot as 5 minutes every. It will generally require weeks to completely get well from probably the most extreme episodes.

“I get up after a seizure and I limp, I cry, it’s horrible,” mentioned Sage, who lives together with her mother and father in Vista. “I’ve ache in my head, my jaw and my tongue and cheeks from biting them. It’s taken the whole lot away from me. It has stopped my entire complete life.”

Due to her seizures, Sage dropped out of highschool after her sophomore 12 months. Driving is a distant reminiscence. Hers isn’t the standard lifetime of a young person.

Solely a really particular kind of affected person is prone to obtain sEEG, somebody for whom mind surgical procedure has develop into a final resort attributable to drug-resistant epilepsy. Sage mentioned the seizure medicine she tried “labored considerably, however not sufficient,” and that almost all produced opposed negative effects, resembling making her really feel “crazy” and “offended after I’m not.”

Sage opted for surgical intervention on the suggestion of Ben-Haim and Jerry Shih, MD, director of the Epilepsy Heart at UC San Diego Neurological Institute, following a multidisciplinary convention about her case.

Based mostly on Sage’s MRI scan, Ben-Haim programmed into ROSA the place every electrode must be inserted, after which ROSA’s robotic arm pivoted to the exact positions for every insertion.

“Every of the electrodes is deliberate with nice accuracy to enter and terminate (finish) in a sure a part of the mind, and to map particular anatomical options alongside its trajectory,” mentioned Ben-Haim, the one neurosurgeon in San Diego County at present performing ROSA-assisted sEEG on adults. (Rady Kids’s Hospital-San Diego has a ROSA for pediatric instances.)

“The place the electrodes go may be very particular for every affected person, primarily based on a really intensive preoperative workup that we do.” (Earlier than the appearance of sEEG, neurosurgeons positioned grid, strip and depth electrodes for intracranial monitoring. These have been typically very difficult procedures.)

When she emerged from anesthesia following the sEEG process at Jacobs Medical Heart at UC San Diego Well being, Sage mentioned she “felt a bit of little bit of ache, however it was very bearable — particularly understanding that that is my probability to get my life again.”

The electrodes remained inside Sage’s mind for every week, mapping her seizures. The ensuing information (nonetheless being analyzed) will assist decide one of the best therapy. This will embrace laser-assisted ablation or resection within the area of the mind inflicting the seizures.

“I simply need to simply cease the seizures,” Sage mentioned, in order that she will pursue a standard life and maybe a profession serving to others via their epilepsy journeys.

“I need to be that particular person for another person,” she mentioned.

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