睿米机器人结合术中B超在颅内微小病变手术中的临床应用

Microsurgery assisted by Remebot-robot and intraoperative B-ultrasound for tiny intracranial lesions:report of 21 cases

目的探讨睿米机器人及术中B超在颅内微小病变手术中的临床应用效果。方法回顾性分析2018年10月至2020年9月在睿米机器人及术中B超辅助下显微手术切除的21例颅内微小病变的临床资料。结果21例病变最大径1~3 cm,平均1.8 cm;位于额叶8例、颞叶4例、顶叶5例、枕叶4例。21例病灶定位准确率为100%,机器人系统显示定位误差在2 mm以内。术后复查MRI显示病灶均全切除。术后症状改善19例,无明显变化2例。术后均没有严重的并发症,无新发神经功能障碍,无手术死亡病例。术后病理检查结果显示低级别星形细胞瘤6例,间变性星形细胞瘤3例(WHOⅢ级),胶质母细胞瘤3例,海绵状血管瘤5例,脑膜瘤4例。21例术后随访3~12个月,复查MRI未见复发。结论睿米机器人及术中B超有助于精确定位颅内微小病灶,减少手术创伤,提高全切除率。

Objective To explore the efficacy of microsurgery assisted by Remebot-robot and intraoperative B-ultrasound for the patients with tiny intracranial lesions(TIL).Methods The clinical data of 21 patients with TIL who underwent microsurgery assisted by Remebot-robot and intraoperative B-ultrasound from October 2018 to September 2020 were retrospectively analyzed.Results The maximum diameter of lesions ranged from 1 cm to 3 cm,with an average of 1.8 cm.The lesions were located in frontal lobe in 8 patients,temporal lobe in 4,pariental lobe in 5 and occipital lobe in 4.The positioning accuracy of 21 patients was 100%,and the robot system showed that the positioning deviation was within 2 mm.Postoperative MRI showed that all the lesions were completely resected.The symptoms were improved in 19 patients,and no change in 2.There were no serious postoperative complications,no new neurological dysfunction,and no surgical deaths.Postoperative pathological examination showed low-grade astrocytoma in 6 patients,anaplastic astrocytoma(WHO gradeⅢ)in 3,glioblastoma in 3,cavernous hemangioma in 5,and meningiomas in 4.The followed up(range,3~12 months)showed no recurrence in all the patients.Conclusions The Remebot-robot and intraoperative B-ultrasound help to accurately locate the TIL,which can reduce the surgical trauma and increase the total resection rate.