The first "robot implanted brain pacemaker for refractory epilepsy" surgery in Hunan was completed in the Provincial Brain Hospital

Surgical scene.

Red Net Moment, January 26 (Correspondent Yang Wen) On January 25, Hunan Provincial Brain Hospital (Hunan Second People's Hospital) took the lead in the province to carry out robot implanted brain pacemaker (also known as "intracranial deep electrical stimulator") to treat refractory epilepsy surgery, and the robot successfully implanted two special electrodes into the predetermined position of the man's skull, and the actual implantation position and the preset target after surgery were accurately coincided. With the assistance of robots, the doctor team can formulate and implement the surgical plan more efficiently and accurately, which greatly improves the efficiency and accuracy of the operation, which has the advantages of minimally invasive, precise, safe, effective, controllable, and reversible, bringing good news to patients with refractory epilepsy.

Men have suffered from epilepsy for 20 years and have suffered physically and mentally

Mr. Gu (pseudonym), 40, has suffered from epilepsy for 20 years. In 2001, when he was a sophomore in college, he was surrounded by his classmates after getting up once, and everyone asked him why he was screaming and shaking at night, waking up his classmates, whether he was having nightmares, and he himself was completely ignorant. Later, in the process of playing football with his classmates, he suddenly fell to the ground, his limbs twitched, his eyes turned up, and his mouth was salivating, and he was diagnosed with epilepsy after being sent to the hospital by his classmates.

Since then, his life has changed dramatically, his father took him around to seek medical treatment, and in order to prevent accidental injuries, his original favorite sports have been reduced, his friends have become fewer and fewer, and his personality has become more and more withdrawn. Since 2014, his condition has been getting worse, drug control is not ideal, and epilepsy has two or three seizures per month. In recent years, not only his rice bowl and mobile phone have been broken and broken due to the onset of illness, but his left ribs, right shoulder blade, and right facial bone have been broken and broken, and the onset of the disease has also been accompanied by urinary and urinary incontinence.

40 years old is in the prime of life, there are parents and two-year-old daughters, should be the pillar of the family, can not make a living for themselves to support the family, but also need to be cared for by elderly parents. Epilepsy causes him great psychological stress, leading to insomnia, depression, depression, depression and even suicidal impulses, and physical illness and psychological problems intertwine to lead to a vicious circle. Recently, due to lack of sleep, anxiety and depression, the seizures induced by the further increase, making him suffer and suffer. After learning that epilepsy could be treated through surgery, he and his father came to the Epilepsy Center of Hunan Brain Hospital to use surgery to solve the vicious circle of physical and mental problems and change the status quo and put life on the right track.

Undergo systematic testing to identify indications for surgery

At the hospital's epilepsy center, Mr. Gu underwent a series of physical and mental examinations, in which video EEG monitoring found abnormal discharge in multiple areas of the skull, and psychological scale measurements found that he had moderate depression. The Epilepsy Center invited the Hospital Depression Diagnosis and Treatment Center to consult with drugs to improve Mr. Gu's sleep and emotional problems, and on December 24, 2021, a "general anesthesia intubation robot assisted deep intracranial electrode implantation" was carried out to continuously monitor the intracranial electrode EEG for Mr. Gu. Lu Jun, director of the epilepsy center, said that because the location of the epileptic lesion could not be accurately located in the early stage, this operation was to more accurately lock the lesion and lay the foundation for follow-up treatment. A total of 6 seizures were monitored within one month after surgery, of which 3 were initiated by the left hippocampus and 3 times by the right hippocampus.

Due to the presence of multifocal epileptogenic foci on both sides of Mr. Gu's bilateral temporal lobe and other parts of the EEG monitoring of intracranial electrodes, craniotomy could not be performed to completely remove the epileptogenic foci. After communicating with the patient and his family, the epilepsy center team developed a surgical plan for him to implant a brain pacemaker.

Robot-guided, precise implantation of "electrodes"

On January 25, Lu Jun, Professor Huang Hongxing of the Department of Neurosurgery and director of the Epilepsy Center of the hospital, led the medical team to successfully bury two special electrodes in the bilateral intracranial preset targets according to the predetermined plan and under the guidance of the surgical robot. After CT comparing the implantation position with the preset target, the surgical team implanted the battery under the skin on the right side of Mr. Gu's chest and connected it with the brain electrodes, and a sophisticated "intracranial electrical stimulation system" was installed. After being sutured and restored, this set will become part of Mr. Gu's body. The impedance of the deep brain stimulator was normal after surgery, and it is planned to be discharged from the hospital in the near future and started in about three weeks.

Professor Huang Hongxing introduced that brain pacemaker surgery is currently an important means of treating intractable epilepsy, Parkinson's disease, refractory obsessive-compulsive disorder and other diseases, through the special electrodes are accurately buried in the deep nuclei of the brain, the in vitro program control sets electrical stimulation parameters, inhibit pathological electrical activity, is a minimally invasive reversible adjustable surgical technique to improve clinical symptoms.

Lu Jun introduced that in this operation, the robot gave full play to the advantages of its combination of "intelligence" and "precision", avoided important structures in the skull before surgery, and improved surgical safety; accurate positioning during surgery, while ensuring surgical accuracy, simplified the surgical process and shortened the operation time, which not only improved the efficiency compared with the traditional surgery that relied on the stereotactic framework, but also greatly reduced the patient's trauma and risk.

After the operation, through the stimulation of the electrodes, it can help Mr. Gu to continuously reduce the number of seizures, control the symptoms of seizures, improve his mood and cognition, gradually reverse the physical and psychological conditions, form a virtuous circle, and continuously improve the quality of life.