Robot Assisted MRI-Guided LITT of the Anterior, Lateral, and Medial Temporal Lobe for Temporal Lobe Epilepsy

Kunal Gupta, Adam S. Dickey, Ranliang Hu, Edward Faught, Jon T. Willie

Research output: Contribution to journalArticlepeer-review

Abstract

Robotic systems have fundamentally altered the landscape of functional neurosurgery. These allow automated stereotaxy with high accuracy and reliability, and are rapidly becoming a mainstay in stereotactic surgeries such as deep brain stimulation (DBS), stereoelectroencephalography (SEEG), and stereotactic laser ablation/MRI guided laser interstitial thermal therapy (MRgLITT). Robotic systems have been effectively applied to create a minimally invasive approach for diagnostics and therapeutics in the treatment of epilepsy, utilizing robots for expeditious and accurate stereotaxy for SEEG and MRgLITT. MRgLITT has been shown to approach open surgical techniques in efficacy of seizure control while minimizing collateral injury. We describe the use of robot assisted MRgLITT for a minimally invasive laser anterior temporal lobotomy, describing the approach and potential pitfalls. Goals of MRgLITT are complete ablation of the epileptogenic zone and avoiding injury to uninvolved structures. In the middle fossa these include structures such as cranial nerves in the skull base and cavernous sinus and the thalamus. These can be mitigated with careful trajectory planning and control of laser ablation intensity.

Original languageEnglish
Article number572334
JournalFrontiers in Neurology
Volume11
DOIs
StatePublished - Nov 27 2020

Keywords

  • LITT (laser interstitial thermal therapy)
  • ROSA (robotized stereotactic assistant)
  • SEEG (stereoelectroencephalography)
  • temporal lobe epilepsy
  • temporal lobectomy

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